Juliet M Foster

Juliet M Foster
Woolcock Institute of Medical Research

BSc PhD

About

70
Publications
19,618
Reads
How we measure 'reads'
A 'read' is counted each time someone views a publication summary (such as the title, abstract, and list of authors), clicks on a figure, or views or downloads the full-text. Learn more
1,556
Citations
Citations since 2016
29 Research Items
1297 Citations
2016201720182019202020212022050100150200
2016201720182019202020212022050100150200
2016201720182019202020212022050100150200
2016201720182019202020212022050100150200

Publications

Publications (70)
Article
Full-text available
Objective: Young people with asthma often lack engagement in self-management. Smartphone apps offer an attractive, immediate method for obtaining asthma information and self-management support. In this research we developed an evidence-based asthma app tailored to young people's needs, created using a participatory design approach to optimise user-...
Article
Full-text available
Adherence to medication comprises a multiphased temporal process involving (1) initiation of prescribed therapy, (2) implementation as prescribed, and (3) subsequent persistence. Medication adherence remains suboptimal in most patients with long-term respiratory conditions such as asthma and chronic obstructive pulmonary disease (COPD). Interventio...
Article
People with severe asthma are thought to face a sizeable daily disease burden. This study aimed to explore the little-known life experiences of people living with severe asthma. Adults with severe asthma were invited for telephone interview. Semistructured interviews were conducted until no new themes emerged. The 25 interviews were recorded, trans...
Article
Full-text available
Use of electronic monitoring devices (EMDs) for inhalers is growing rapidly because of their ability to provide objective and detailed adherence data to support clinical decision making. There is increasing potential for the use of EMDs in clinical settings, especially as cost-effectiveness is realized and device costs reduce. However, it is import...
Article
Full-text available
Background: Analysis of patterns of breathing over time may provide novel information on respiratory function and dysfunction. Devices that continuously record and analyze breathing rates may provide new options for the management of respiratory diseases. However, there is a lack of information about design characteristics that would make such devi...
Article
Rationale: Poor adherence with asthma controller medication contributes to worse symptom control and increased exacerbation risk. Adherence is often expressed as the mean proportion of prescribed doses taken over a period of 6-12 months. New metrics may capture individual day-to-day variability patterns linked with distinct clinical outcomes. Obj...
Article
Background and objective: Caring for people with severe asthma and chronic obstructive pulmonary disease (COPD) can impair the quality of life (QoL) of the carer. We aimed to describe the QoL and needs of severe asthma and COPD carers. Methods: Carers of severe asthma (n = 89) and COPD (n = 48) completed an online cross-sectional survey assessin...
Article
Full-text available
Inhaled corticosteroids (ICS) suppress eosinophilic airway inflammation in asthma, but patients may not adhere to prescribed use. Mean adherence—averaging total doses taken over prescribed—fails to capture many aspects of adherence. Patients with difficult-to-treat asthma underwent electronic monitoring of ICS, with data collected over 50 days. The...
Article
Purpose: To evaluate the effectiveness of a pilot community pharmacy care model for patients with chronic obstructive pulmonary disease (COPD) to improve: 1) inhaler technique; 2) medication adherence; and 3) uptake of non-pharmacological treatment and prevention activities. Patients and methods: Forty "host" pharmacies in Sydney were invited to...
Article
Full-text available
Introduction Family carers and significant others play a fundamental role in the well-being of people with severe asthma. This study aimed to investigate the challenges faced by family carers/significant others of people with severe asthma, to understand if there is an unmet need and to explore coping strategies. Methods Carers of people with seve...
Article
Objective: This pilot aimed to test the engagement, acceptability, and usefulness of a goal-setting smartphone app, Kiss myAsthma, in young people with asthma. Methods: Young people aged 15–24 years old were invited to trial a smartphone app for asthma management. A mixed-methods approach combined quantitative analysis of self-report questionnaires...
Article
Full-text available
Objectives: Inappropriate medication prescribing is a recognized clinical problem in nursing home residents of whom many have polypharmacy. However, results about the effectiveness of medication reviews targeted at improving prescribing and deprescribing have been equivocal. We therefore examined barriers and facilitators of conducting medication r...
Article
Background: Studies have shown that COPD screening by community pharmacists is effective, but it is unknown if it can be successfully implemented in Australian pharmacies. Objective: We aimed to investigate the pharmacist-perceived barriers and facilitators to the implementation of a community pharmacy-based COPD screening service guided by impl...
Article
Objective: Our aim was to conduct a systematic review and synthesis of qualitative evidence exploring the lived experience of adults with severe asthma. Data sources: We searched MEDLINE via OvidSP, PsycINFO via OvidSP, PubMed, CINAHL, EMBASE, Sociological Abstracts, Google Scholar, the journals Qualitative Health Research and Qualitative Resear...
Article
Background: Asthma is often suboptimally controlled, in part due to patients' disease knowledge. Understanding patients' knowledge, prior to education may help in individualizing content. However, there are no well validated or internationally relevant patient asthma knowledge questionnaires available. Objective: To translate and validate the ri...
Article
Full-text available
Background and objective Case finding of patients at risk of COPD by community pharmacists could identify a substantial number of people with undiagnosed COPD, but little is known about the feasibility and effectiveness of pharmacy-based COPD case finding using microspirometry. The objective of this study was to assess the feasibility and effective...
Article
Full-text available
Background While chronic morbidity and mortality from COPD is well documented, little is known about the treatment burden faced by patients with COPD. Subjects and methods Patients with severe airflow obstruction (forced expiratory volume in 1 second [FEV1] <50% predicted) representing different age-groups, sex, and number of comorbidities partici...
Article
Introduction Little is known about patients' perceptions of electronic inhaler reminders, which have emerged in recent years as adherence promotion aids. This study explored asthma patients' attitudes toward the acceptability and utility of inhaler reminders. Methods Participants from a 6-month cluster randomized controlled trial who received remi...
Article
Background: To investigate the performance and patient acceptability of an inhaler electronic monitoring device in a real-world childhood asthma population. Methods: Children 6 to 15 years presenting with asthma to the hospital emergency department and prescribed inhaled corticosteroids were included. Participants were randomized to receive a devic...
Article
Full-text available
Background: Although the prevalence of mental illness among young people with asthma is known to be twice the rate of the wider population, none of the asthma apps reported have acknowledged or attempted to include psychological support features. This is perhaps because user involvement in the development of asthma apps has been scarce. User involv...
Article
Full-text available
Aim: Patient adherence is integral to the effectiveness of prescribed treatment, and is associated with beneficial disease outcomes, yet in adolescents with cystic fibrosis, adherence is often sub-optimal. Multiple factors may contribute to treatment adherence, including disease knowledge and self-efficacy. In adolescents with cystic fibrosis: (i)...
Article
Full-text available
Background: Analysis of patterns of breathing over time may provide novel information on respiratory function and dysfunction. Devices that continuously record and analyze breathing rates may provide new options for the management of respiratory diseases. However, there is a lack of information about design characteristics that would make such devi...
Article
Full-text available
Adequate medication adherence is key for optimal benefit of pharmacological treatments. A wealth of research has been conducted to understand and identify opportunities to intervene to improve medication adherence, but variations in adherence definitions within prior research have led to ambiguity in study findings. The lack of a standard taxonomy...
Article
Full-text available
The circumstances and drivers of the decision to initiate, implement, or persist with a medication differ for individuals at each developmental stage. For school-age children with asthma, the social environment of their family's cultural beliefs and the influence of peer networks and school policies are strong determinants of medication adherence....
Conference Paper
Introduction: People with severe asthma are thought to face a sizeable burden, beyond that of people with milder disease. Aims: To explore the little-known life experiences of people living with severe refractory asthma (SRA). Methods: Patients identified with SRA via the Australasian Severe Asthma Network and/or specialist asthma clinics across 7...
Article
Full-text available
Adherence to preventive asthma treatment is poor, particularly in children, yet the factors associated with adherence in this age group are not well understood. Adherence was monitored electronically over 6 months in school-aged children who attended a regional emergency department in New Zealand for an asthma exacerbation and were prescribed twice...
Article
Full-text available
Background: Primary-care based randomized controlled trials (RCTs) build an important evidence base for general practice but little evidence exists about barriers to recruitment which often hamper such trials. Methods: GPs participating in a cluster RCT that tested interventions for improving medication adherence and asthma control completed a surv...
Article
Full-text available
Objective: Poor medication adherence contributes to uncontrolled asthma in primary care. Good doctor-patient communication around adherence increases patients' medication taking but General Practitioners (GPs) often feel poorly equipped to provide effective adherence counseling. This study aimed to assess the feasibility and usefulness of adherenc...
Article
Full-text available
Background Poor adherence contributes to uncontrolled asthma. Pragmatic adherence interventions for primary care settings are lacking. Objective To test the effectiveness of 2 brief general practitioner (GP)-delivered interventions for improving adherence and asthma control. Methods In a 6-month cluster randomized 2 × 2 factorial controlled trial...
Article
Full-text available
Side-effect concerns impede adherence with inhaled corticosteroids (ICS) and often underlie poor asthma control. We developed a brief version (ICQ-S) of the 57-item Inhaled Corticosteroids side-effect Questionnaire (ICQ) to facilitate side-effect monitoring in busy clinics. Part 1: After completion by 482 patients with doctor-diagnosed asthma, each...
Article
In the past decade, rapid technological developments have advanced electronic monitoring devices (EMD) for asthma inhalers beyond simple recording of actuations to providing adherence promotion features and detailed information about patterns of medication use. This article describes currently available EMDs, discusses their utility and limitations...
Article
Full-text available
Asthma management requires adequate adherence to many recommendations, including therapy, monitoring of asthma control, avoidance of environmental triggers, and attending follow-up appointments. Poor adherence is common in patients with asthma and is often associated with increased health care use, morbidity, and mortality. Many determinants of poo...
Article
Full-text available
The SmartTrack (ST) is a new adherence monitoring device for pressurized metered-dose inhalers (pMDI), with remote upload and ringtone reminder capabilities. Our aim was to assess its reliability and patient acceptability. Baseline Quality Control (QC): Actuation log accuracy and device functionality tests were undertaken. Simulated Patient Use: Sa...
Chapter
Full-text available
Psychological comorbidity in functional respiratory disorders is common and, if not fully appreciated, may lead to inaccurate investigations, treatments, and diagnosis. For this reason, it is important to recognize that comorbid psychological conditions may interact with functional respiratory symptoms for a prolonged period of time without identif...
Article
Full-text available
Asthma guidelines advise addressing adherence at every visit, but no simple tools exist to assist clinicians in identifying key adherence-related beliefs or behaviours for individual patients. To identify potentially modifiable beliefs and behaviours that predict electronically recorded adherence with controller therapy. Patients aged ≥ 14 years wi...
Chapter
Full-text available
Difficult-to-treat severe asthma constitutes approximately 5–10% of the asthmatic population, and continues to present a considerable therapeutic challenge. Use of the pragmatic definitions over the past 10 years has led to an improved delineation of these patients. This monograph gathers expertise in the paediatric and adult severe asthma fields....
Article
Patient-reported outcomes provide new insights into the dynamics of asthma management. Further to asthma control and quality of life, self-reported side effects of treatment can be assessed with the validated Inhaled Corticosteroid Questionnaire (ICQ). To compare patient-reported side effects between the inhaled corticosteroids ciclesonide and flut...
Article
Full-text available
Negative affectivity is a measure of anxiety associated with increased reporting of symptoms. Few studies have explored this association with respect to drug-induced symptoms in patients taking medication for a chronic disease in real life. In this cross-sectional study we examined the relationship between negative affectivity and self-reported sid...
Article
Full-text available
Patient-reported outcomes such as Quality of Life often play an important part in the efficacy assessment of drug treatment. Although instruments that measure quality of life can detect the positive effects of treatments on health status, they may not measure the effect of negative treatment-related symptoms. Patients often fail to spontaneously re...
Article
Full-text available
Our professional development plan aimed to improve the primary care management of acute asthma, which is known to be suboptimal. We invited 59 general practices in Grampian, Scotland to participate. Consenting practices were randomised to early and delayed intervention groups. Practices undertook audits of their management of all acute attacks (exc...
Article
Full-text available
Patient-reported side effect questionnaires offer a simple method for the systematic measurement of drug-related side effects. In order to measure patients' inhaled corticosteroids (ICS) related side effect perceptions the 14-day retrospective Inhaled Corticosteroid Questionnaire (ICQ) was developed. In this research we aim to assess the construct...
Article
The range and extent of inhaled corticosteroid (ICS) side effects experienced by patients in the general community are likely to be underestimated. To identify the side effects of ICS perceived by patients in the community and, through the use of a self-report questionnaire, measure their intensity, prevalence and relationship with daily medication...
Article
Full-text available
Professional development requires practitioners to identify sub-optimal practice, and develop plans to improve care. The General Practice Airways Group (GPIAG) acute asthma development programme aims to facilitate this process.Method:We invited 59 GP practices, in Grampian, Scotland, to participate. We randomised consenting practices to interventio...
Conference Paper
Side effects of inhaled corticosteroids (ICS) are often described in the literature as infrequent and of minor consequence to patients' health. However, little is known about patients' perceptions of side effects related to ICS use.
Article
Although COPD is a huge healthcare burden globally, differences in international management are difficult to analyse. This pilot study examines how COPD is managed in primary care in 11 countries: 3 UK (England, Scotland and Wales), 8 Non-UK (Netherlands, Spain, Republic of Ireland, Denmark, Sweden, Norway, Australia, and New Zealand).MethodA multi...
Article
Despite Guidelines for the Management of Asthma there is a concern that the management of acute asthma in primary care remains sub-optimal. The General Practice Airways Group (GPIAG) has responded to this concern by designing an acute asthma audit tool for use as part of a Professional Development PlanMethod:59 GP practices, in Aberdeen and Peterhe...
Article
Recent epidemiological surveys show that approximately 20 % of the general population suffer from airway disease. Inhaled Corticosteroids (ICS) are often prescribed for these diseases. It is commonly thought that side effects of ICS are very limited and appear rarely. Effectiveness studies show 3-9% self reported side effects. These side effects ha...
Article
Although COPD is a huge healthcare burden globally it remains difficult to analyse differences in international management, share successful management strategies across countries or implement internationally agreed protocols and guidelines. This pilot study examines how COPD is managed in primary care in ten separate countries to understand variat...