Breathe Well South America

About

Breathe Well South America is a four-year research programme (2024-2028) funded by the National Institute for Health and Care Research (NIHR). The research addresses poor and inequitable access to quality primary healthcare for patients with Chronic obstructive pulmonary disease (COPD).

In South America, COPD is the fourth leading cause of death, with a high hospital healthcare and societal burden. It disproportionately affects people living in poverty and at least three-quarters of cases remain undiagnosed and, therefore, untreated.

Co-led with the Universidad Científica del Sur (UCSUR) in Peru, the Breathe Well South America partnership also brings together the Institute for Clinical Effectiveness and Health Policy (IECS) in Argentina, University of São Paulo (USP) in Brazil, University College London (UCL), and the International Primary Care Respiratory Group (IPCRG).

Through five work packages, the research programme will develop primary care research capacity in order to improve earlier identification and management of COPD. Partners will assess the current context and quality of COPD care in each country/region, develop a set of COPD quality indicators and an identification and treatment pathway for patients in primary care. They will test the feasibility of these in different settings and model the preliminary cost-effectiveness of the pathway and its potential impact on health inequalities.

The lead Universities in Argentina, Brazil and Peru are working with 2-3 less-experienced Universities/Institutes to recruit 45-50 local general practices in each country, train their staff and conduct the research within their communities. Capacity-building at individual, institutional and environmental level is a fundamental part of the programme to ensure sustainability.

Community and stakeholder engagement is also integral to the programme. We are engaging stakeholders from all relevant groups, including community members and patients, so that they can advise and input into the research throughout, ensuring that the findings are taken up in healthcare policy and practice.

Work packages

A range of different research methods will be used across three research work packages (WPs).

• WP1 will evaluate the quality of COPD care and healthcare records. Data from interviews with relevant stakeholders will be combined with new/existing surveys and primary healthcare data records.
• WP2 will co-create pathways sharing tasks between the healthcare and community teams to identify people with COPD and provide treatment, including supporting those diagnosed to manage their own condition better. This pathway will then be tested out in a few general practices.
• WP3 will evaluate the cost-effectiveness of the pathway and its impact on health inequalities.

Two additional work packages will run throughout:

• WP4 will focus on engaging stakeholders from all relevant groups, including community members and patients, so that they can advise and input into the research from start to finish and help to ensure that the findings are taken up in healthcare policy and practice. A network of community members will be developed to work within and across countries, advising the research and advocating for future policy change.
• WP5 will focus on training the different staff required to conduct the research, working with Universities, clinical organisations and funders to provide a framework for the future.