Horizon CDT Research Highlights

Research Highlights

How to influence patients behavioural change using context data

  Vanja Ljevar (2017 cohort)   www.nottingham.ac.uk/~psxvl


Patients should be able to control their asthma by regular use of inhalers, hence preventing asthma exacerbations and even death. However, asthma adherence is poor, resulting in: severe symptoms and asthma attacks; considerable negative impact on patients’ lives and a significant care spending (Lieshout et al, 2008). A proactive, rather reactive health care is possible through the improvement of patient asthma-management, as long as we can understand what leads to a better adherence and how can this habitualness be created. This means understanding the asthmatics, their psychological traits and the context of adherence-related behaviour (Dow et al, 2001; Wright et al, 2004).

The Question

Therefore, this research will focus on exploring a behavioural change in terms of patients’ behaviour, asthma adherence and control. In other words, the main research question will be:

What influences patients' behavioural change and leads to a higher level of adherence? This question will be investigated using context data that encompasses various factors – psychological, situational, environmental and behavioural.

A holistic approach

A holistic approach

What will be done?

The first part of this PhD will be exploratory and look at current asthma research and perceptions and attitudes patients and non-patients have about asthma (based on the Health Belief Model). This will be done using predominantly open-source data from social media and potentially interviews and there will be an overview of factors that are important in predictions related to levels of adherence, using a medical app called MyAsthma.

The second stage commences with an in-depth exploration of psychological traits that influence patients’ behaviour, through surveys and using novel data collection methodologies, such as data crowdsourcing. The questions that will be responded are: which are other factors that could be relevant for habit creation/prediction in terms of inhaler use (what are their individual and group-based variable importance) and how can they be collected, connected and understood.


Answering these complex questions can inform the development of the future delivery devices and inhalers, in other words – what kind of context data should be collected to positively influence patients’ behaviour. Following these finding, we will also be able to understand the asthmatics’ lifestyle and identity, reveal natural groups of asthmatics, based on patterns in their behaviour and psychological traits. Lastly, this research can open the door to the assessment of types of interventions that are the most likely to influence behaviour in each of these groups.

Multidisciplinary approach

The drive toward a digital-based economy is bringing every asthmatic sufferer, their digital and environmental footprints and activities into one digital realm. Having insights from multiple fields could be the key to reduction of preventable deaths. The multidisciplinary nature of this research will combine predictive algorithms that can be used as risk stratification tools with medical purposes, along with psychological aspects. Taking into account ethical considerations, an ethical process will be subject to approval by the University of Nottingham and GSK, whereas data collected during this PhD will be stored and managed following the Data Protection principles.


  1. Van Lieshout, R. J., & MacQueen, G. (2008). Psychological factors in asthma. Allergy, Asthma & Clinical Immunology, 4(1), 12.
  2. Dow, L., Fowler, L., Phelps, L., Waters, K., Coggon, D., Kinmonth, A. L., & Holgate, S. T. (2001). Prevalence of untreated asthma in a population sample of 6000 older adults in Bristol, UK. Thorax, 56(6), 472-476.
  3. Wright, R. J., Mitchell, H., Visness, C. M., Cohen, S., Stout, J., Evans, R., & Gold, D. R. (2004). Community violence and asthma morbidity: the Inner-City Asthma Study. American journal of public health, 94(4), 625-632.

This author is supported by the Horizon Centre for Doctoral Training at the University of Nottingham (RCUK Grant No. EP/L015463/1) and Glaxo Smith Kline.