Dr Joseph Clark's Outputs (21)

BREATHLEssness in INDIA (BREATHE-INDIA): realist review to develop explanatory programme theory about breathlessness self-management in India (2025)
Journal Article
Clark, J., Salins, N., Sherigar, M., Williams, S., Pearson, M., Rao, S. R., Spathis, A., Bhat, R., Currow, D. C., Fraser, K., Simha, S., & Johnson, M. J. (2025). BREATHLEssness in INDIA (BREATHE-INDIA): realist review to develop explanatory programme theory about breathlessness self-management in India. NPJ Primary Care Respiratory Medicine, 35(1), Article 13. https://doi.org/10.1038/s41533-025-00420-2

Breathlessness is highly prevalent in low and middle-income countries (LMICs). Low-cost, non-drug, breathlessness self-management interventions are effective in high-income countries. However, health beliefs influence acceptability and have not been... Read More about BREATHLEssness in INDIA (BREATHE-INDIA): realist review to develop explanatory programme theory about breathlessness self-management in India.

ERS guideline recommendation on airflow for breathlessness: the pitfalls of applying GRADE evidence ratings to complex non-pharmacological interventions (2025)
Journal Article
Luckett, T., Swan, F., Clark, J., Roberts, M., Pearson, M., Hutchinson, A., Currow, D., Kochovska, S., Crooks, M., Smith, T., & Johnson, M. (2025). ERS guideline recommendation on airflow for breathlessness: the pitfalls of applying GRADE evidence ratings to complex non-pharmacological interventions. European respiratory journal, 65(2), Article 2402244. https://doi.org/10.1183/13993003.02244-2024

"I'm living in a 'no' world now…"- A qualitative study of the widespread impact of living with chronic breathlessness, and experiences of identification and assessment of this symptom in an older, frail community-based population (2025)
Journal Article
Elliott-Button, H., Johnson, M. J., Hutchinson, A., Currow, D. C., & Clark, J. (2025). "I'm living in a 'no' world now…"- A qualitative study of the widespread impact of living with chronic breathlessness, and experiences of identification and assessment of this symptom in an older, frail community-based population. NPJ Primary Care Respiratory Medicine, 35(1), Article 5. https://doi.org/10.1038/s41533-024-00409-3

Chronic breathlessness is a debilitating symptom with detrimental impact on individuals and carers. However, little is known about the experiences of community-dwelling, frail, older adults living with chronic breathlessness. To explore, (i) the psyc... Read More about "I'm living in a 'no' world now…"- A qualitative study of the widespread impact of living with chronic breathlessness, and experiences of identification and assessment of this symptom in an older, frail community-based population.

Breathlessness without borders: a call to action for global breathlessness research (2024)
Journal Article
Clark, J. D., Binnie, K., Bond, M., Crooks, M., Currow, D. C., Curry, J., Elsey, H., Habib, M., Hutchinson, A., Soyiri, I., Johnson, M. J., Nair, S., Rao, S., Siqueira-Filha, N., Spathis, A., & Williams, S. (2024). Breathlessness without borders: a call to action for global breathlessness research. NPJ Primary Care Respiratory Medicine, 34(1), Article 26. https://doi.org/10.1038/s41533-024-00384-9

It is likely that the burden of breathlessness in low and middle-income countries (LMICs) is much higher than has been estimated using calculations of disease burden and expected prevalence of the symptom. However, most breathlessness research has be... Read More about Breathlessness without borders: a call to action for global breathlessness research.

BREATHLEssness in INDIA (BREATHE-INDIA)–Study protocol for the co-design of a community breathlessness intervention in India using realist methods and intervention mapping (2023)
Journal Article
Clark, J., Salins, N., Pearson, M., Spathis, A., Currow, D. C., Williams, S., & Johnson, M. (2023). BREATHLEssness in INDIA (BREATHE-INDIA)–Study protocol for the co-design of a community breathlessness intervention in India using realist methods and intervention mapping. PLoS ONE, 18(11 November), Article e0293918. https://doi.org/10.1371/journal.pone.0293918

Background Breathlessness that persists despite treatment of causal disease(s) is disabling, associated with high therapy-related costs and poor socioeconomic outcomes. Low resource countries bear a disproportionate burden of respiratory problems, of... Read More about BREATHLEssness in INDIA (BREATHE-INDIA)–Study protocol for the co-design of a community breathlessness intervention in India using realist methods and intervention mapping.

Views and experiences of opioid access amongst palliative care providers and public representatives in a low-resource setting: A qualitative interview study (2023)
Journal Article
Clark, J., Salins, N., Daniel, S., Currow, D. C., Jones, L., Pearson, M., Bunton, R., Mankel, J., Braithwaite, C., Gilchrist, M. M., & Johnson, M. J. (2023). Views and experiences of opioid access amongst palliative care providers and public representatives in a low-resource setting: A qualitative interview study. PLOS Global Public Health, 3(9), Article e0002401. https://doi.org/10.1371/journal.pgph.0002401

Opioids (e.g. morphine) are affordable, effective interventions for cancer-related pain. However, equity of access to this key medication remains a global challenge, particularly in low- and middle-income countries. We aimed to explore views of palli... Read More about Views and experiences of opioid access amongst palliative care providers and public representatives in a low-resource setting: A qualitative interview study.

The roles and experiences of informal carers providing care to people with advanced cancer in Africa—A systematic review and critical interpretive analysis (2023)
Journal Article
Gambe, R. G., Clark, J., Meddick-Dyson, S. A., Ukoha-Kalu, B. O., Nyaaba, G. N., & Murtagh, F. E. (2023). The roles and experiences of informal carers providing care to people with advanced cancer in Africa—A systematic review and critical interpretive analysis. PLOS Global Public Health, 3(4), Article e0001785. https://doi.org/10.1371/journal.pgph.0001785

There is an increasing prevalence of cancer in Africa with approximately 80% of cancers diagnosed at an advanced stage. High out-of-pocket healthcare costs and overstretched health systems lead to heavy reliance on informal carers for cancer care. Th... Read More about The roles and experiences of informal carers providing care to people with advanced cancer in Africa—A systematic review and critical interpretive analysis.

A non-randomised controlled study to assess the effectiveness of a new proactive multidisciplinary care intervention for older people living with frailty (2023)
Journal Article
Murtagh, F. E., Okoeki, M., Ukoha-kalu, B. O., Khamis, A., Clark, J., Boland, J. W., Pask, S., Nwulu, U., Elliott-Button, H., Folwell, A., Harman, D., & Johnson, M. J. (2023). A non-randomised controlled study to assess the effectiveness of a new proactive multidisciplinary care intervention for older people living with frailty. BMC Geriatrics, 23(1), Article 6. https://doi.org/10.1186/s12877-023-03727-2

Background
Integrated care may improve outcomes for older people living with frailty. We aimed to assess the effectiveness of a new, anticipatory, multidisciplinary care service in improving the wellbeing and quality of life (QoL) of older people li... Read More about A non-randomised controlled study to assess the effectiveness of a new proactive multidisciplinary care intervention for older people living with frailty.

Experiences of a Novel Integrated Service for Older Adults at Risk of Frailty: A Qualitative Study (2023)
Journal Article
Wilson, I., Ukoha-kalu, B. O., Okoeki, M., Clark, J., Boland, J. W., Pask, S., Nwulu, U., Elliott-Button, H., Folwell, A., Johnson, M. J., Harman, D., & Murtagh, F. E. (2023). Experiences of a Novel Integrated Service for Older Adults at Risk of Frailty: A Qualitative Study. Journal of Patient Experience, 10, https://doi.org/10.1177/23743735231199827

The UK has a significant and growing population of older adults with frailty and complex healthcare needs, necessitating innovative care solutions. This study aimed to explore patients’ and carers’ experiences of a novel integrated service that was s... Read More about Experiences of a Novel Integrated Service for Older Adults at Risk of Frailty: A Qualitative Study.

The impact of chronic breathlessness on psychological concerns and quality of life in an older, frail population in primary care (2022)
Thesis
Elliott-Button, H. L. The impact of chronic breathlessness on psychological concerns and quality of life in an older, frail population in primary care. (Thesis). Hull York Medical School, the University of Hull and the University of York. https://hull-repository.worktribe.com/output/4224612

Background Chronic breathlessness is a debilitating symptom with major detrimental impact on individuals, carers, across health care settings. Little is known about prevalence, impact, or experience of breathlessness in the older, frail population.... Read More about The impact of chronic breathlessness on psychological concerns and quality of life in an older, frail population in primary care.

Lower workforce participation is associated with more severe persisting breathlessness (2022)
Journal Article
Clark, J., Chang, S., Kinchin, I., Ferreira, D., Kochovska, S., Morgan, D., Poulos, L. M., Johnson, M. J., Ekström, M., & Currow, D. C. (2022). Lower workforce participation is associated with more severe persisting breathlessness. BMC Pulmonary Medicine, 22(1), Article 93. https://doi.org/10.1186/s12890-022-01861-y

Background: Not being able to work has negative health, social and financial consequences. Persisting breathlessness is prevalent in working-aged people. Is it associated with lower workforce participation? This study, using the South Australian Heal... Read More about Lower workforce participation is associated with more severe persisting breathlessness.

Professionals’, patients’ and families’ views on the use of opioids for chronic breathlessness: A systematic review using the framework method and pillar process (2021)
Journal Article
Reedy, F., Pearson, M., Greenley, S., Clark, J., Currow, D. C., Bajwah, S., Fallon, M., & Johnson, M. J. (in press). Professionals’, patients’ and families’ views on the use of opioids for chronic breathlessness: A systematic review using the framework method and pillar process. Palliative medicine, https://doi.org/10.1177/02692163211032114

Background: In combination with non-pharmacological interventions, opioids may safely reduce chronic breathlessness in patients with severe illness. However, implementation in clinical practice varies. Aim: To synthesise the published literature rega... Read More about Professionals’, patients’ and families’ views on the use of opioids for chronic breathlessness: A systematic review using the framework method and pillar process.

Views and experiences of opioid access amongst palliative care providers and public representatives in a low-resource setting: a qualitative interview study. (2021)
Data
Clark, J. Views and experiences of opioid access amongst palliative care providers and public representatives in a low-resource setting: a qualitative interview study. [Data]

Opioids (e.g. morphine) are affordable, effective interventions for cancer-related pain. However, equity of access to this key medication remains a global challenge, particularly in low- and middle-income countries. We aimed to explore views of palli... Read More about Views and experiences of opioid access amongst palliative care providers and public representatives in a low-resource setting: a qualitative interview study..

A cluster randomised trial of a Needs Assessment Tool for adult Cancer patients and their carers (NAT-C) in primary care: A feasibility study (2021)
Journal Article
Clark, J., Amoakwa, E., Wright-Hughes, A., Blenkinsopp, J., Currow, D. C., Meads, D., Farrin, A., Allgar, V., Macleod, U., & Johnson, M. (2021). A cluster randomised trial of a Needs Assessment Tool for adult Cancer patients and their carers (NAT-C) in primary care: A feasibility study. PLoS ONE, 16(1), Article e0245647. https://doi.org/10.1371/journal.pone.0245647

Background People with cancer often have unidentified symptoms and social care needs. The Needs Assessment Tool-Cancer (NAT-C) is a validated, structured method of assessing patient/ carer concerns and prompting action, to address unmet need. Aims As... Read More about A cluster randomised trial of a Needs Assessment Tool for adult Cancer patients and their carers (NAT-C) in primary care: A feasibility study.

Perceptions and experiences of laws and regulations governing access to opioids in South, Southeast, East and Central Asia: A systematic review, critical interpretative synthesis and development of a conceptual framework (2020)
Journal Article
Clark, J., Gnanapragasam, S., Greenley, S., Pearce, J., & Johnson, M. (in press). Perceptions and experiences of laws and regulations governing access to opioids in South, Southeast, East and Central Asia: A systematic review, critical interpretative synthesis and development of a conceptual framework. Palliative medicine, https://doi.org/10.1177/0269216320966505

© The Author(s) 2020. Background: Opioids are essential medicines. Despite international and national laws permitting availability, opioid access remains inadequate, particularly in South, Southeast, East and Central Asia. Aim: To review evidence of... Read More about Perceptions and experiences of laws and regulations governing access to opioids in South, Southeast, East and Central Asia: A systematic review, critical interpretative synthesis and development of a conceptual framework.

Does the International Narcotics Control Board (INCB) sufficiently prioritise enablement of access to therapeutic opioids? A systematic critical analysis of six INCB annual reports, 1968-2018 (2020)
Journal Article
Clark, J. D., Johnson, M., Fabowale, B., Farrelly, M., & Currow, D. (in press). Does the International Narcotics Control Board (INCB) sufficiently prioritise enablement of access to therapeutic opioids? A systematic critical analysis of six INCB annual reports, 1968-2018. Journal of Global Health Reports, 4, Article e2020042

Background
The International Narcotics Control Board (INCB) has overseen international drug control since 1968 with the dual remit of restricting illicit production and use of controlled substances, whilst enabling access for clinical purposes. Two... Read More about Does the International Narcotics Control Board (INCB) sufficiently prioritise enablement of access to therapeutic opioids? A systematic critical analysis of six INCB annual reports, 1968-2018.

Psychological concerns of Indian women with breast cancer in different national contexts: A systematic review and mixed-methods synthesis (2020)
Journal Article
Daniel, S., Clark, J., Gnanapragasam, S., Venkateswaran, C., & Johnson, M. J. (in press). Psychological concerns of Indian women with breast cancer in different national contexts: A systematic review and mixed-methods synthesis. BMJ supportive & palliative care, https://doi.org/10.1136/bmjspcare-2019-002076

© 2020 Author(s). Background: Breast cancer is becoming the most common cancer among women of Indian origin. However, little is known about the psychological impact of the disease and its treatment among this population. Aim: To improve understanding... Read More about Psychological concerns of Indian women with breast cancer in different national contexts: A systematic review and mixed-methods synthesis.

Identification and assessment of breathlessness in clinical practice: a systematic review and narrative synthesis. (2019)
Journal Article
Elliott-Button, H., Johnson, M. J., Nwulu, U., & Clark, J. (2020). Identification and assessment of breathlessness in clinical practice: a systematic review and narrative synthesis. Journal of pain and symptom management, 59(3), 724-733.e19. https://doi.org/10.1016/j.jpainsymman.2019.10.014

Context: Breathlessness is common in chronic conditions but often goes unidentified by clinicians. It is important to understand how identification and assessment of breathlessness occurs across health care settings, to promote routine outcome assess... Read More about Identification and assessment of breathlessness in clinical practice: a systematic review and narrative synthesis..

A life or “good death” situation? A worldwide ecological study of the national contexts of countries that have and have not implemented palliative care (2018)
Journal Article
Clark, J., Barnes, A., Campbell, M., & Gardiner, C. (2019). A life or “good death” situation? A worldwide ecological study of the national contexts of countries that have and have not implemented palliative care. Journal of pain and symptom management, 57(4), 793-801. https://doi.org/10.1016/j.jpainsymman.2018.12.007

Context: Palliative care advocates argue that service implementation is feasible in all settings. Yet, services have developed patchily in low- and middle-income settings. Beyond Human Development Index indicators, there has been limited engagement w... Read More about A life or “good death” situation? A worldwide ecological study of the national contexts of countries that have and have not implemented palliative care.

Reframing global palliative care advocacy for the sustainable development goal era: A qualitative study of the views of international palliative care experts (2018)
Journal Article
Clark, J., Barnes, A., & Gardiner, C. (2018). Reframing global palliative care advocacy for the sustainable development goal era: A qualitative study of the views of international palliative care experts. Journal of pain and symptom management, 56(3), 363-370. https://doi.org/10.1016/j.jpainsymman.2018.06.009

Context
The World Health Assembly Palliative Care Resolution in 2014 and the inclusion of palliative care within the sustainable development goals raised optimism that palliative care would no longer be a peripheral aspect of global health. However,... Read More about Reframing global palliative care advocacy for the sustainable development goal era: A qualitative study of the views of international palliative care experts.