Bridging gaps in care of chronic lung disease in Vietnam

Background: Chronic lung diseases, such as COPD and asthma, cause more than 3 million deaths each year – mostly in resource-limited settings. Although effective treatments for obstructive lung disease have been shown to reduce exacerbations and improve quality of life, substantial gaps exist between policy and practice. The reasons that affected adults and children fail to receive appropriate treatment are poorly understood.

Vietnam is a middle-income country in southeast Asia where risk factors for chronic obstructive lung disease, such as smoking and indoor air pollution, are common. The prevalence of COPD is estimated to be almost 10% among adults. However, few patients can access effective inhaled medications.

Project details: This project aims to characterise the management of COPD and asthma within four levels of the Vietnamese health system, and to develop simple interventions that will reduce morbidity and mortality due to these diseases.  It is nested within the Vietnam COPD, Asthma and Smoking Cessation (V-CAPS) study, a five-year NHMRC-funded project that aims to reduce exacerbations of chronic lung disease in Vietnam.

The scope ofproject(s) undertaken with this study will depend upon the interest and skills of the successful candidate, following consultation with the supervisor. Specific components of this body of work may include the following:

1.    A prospective cohort study of patients presenting with respiratory symptoms to health facilities within four Provinces of Vietnam, evaluating the diagnostic and treatment pathways. Health care utilisation and the financial burdens of respiratory symptoms will also be assessed.

2.    Evaluation of the availability and affordability of medications to treat asthma and COPD in the private sector in Vietnam. We will use “simulated patients” to explore the management of respiratory illness within pharmacies, the point of entry to the health system for many patients with respiratory symptoms.

3.    To evaluate the prevalence of COPD and asthma within the general community. A prevalence survey will enroll a randomly selected representative sample from urban and rural settings to estimate the prevalence of obstructive lung disease.

Project team: The project is being implemented in Vietnam by the Woolcock Institute of Medical Research, in partnership with collaborators from the Vietnam National Lung Hospital and Bach Mai Hospital. It will be conducted in four Provinces (Ha Noi, Thanh Hoa, Ho Chi Minh City and Ca Mau). The research will be conducted in Vietnam, with periodic visits to Vietnam required throughout the project.

Desired capabilities: This project is suitable for students with an interest in clinical epidemiology and health policy. Clinical experience will be an advantage. Suitable candidates will be cross-culturally competent and motivated by a desire to improve health care in resource-limited settings.

Supervisors: Dr Greg Fox, Professor Joel Negin (Australia), and Dr Nguyen Thu Anh (Woolcock Institute, Vietnam).

Timing: Approximately October 2017 to 2020.

Funding: Some funding for travel to Vietnam will be provided to cover the period of field work.