Professor Alister Neill
University of Otago, Wellington
BSc, MB ChB, Dip Anaesth, FRACP, Sleep Medicine (11), MD
Alister is a Professor in the Department of Medicine, UOW and Respiratory & Sleep Physician at Wellington Hospital (CCDHB).
His research interests include: the epidemiology and pathophysiology of obstructive sleep apnoea (OSA), its relationship to cardiovascular disease, sleep health disparity, new sleep health technologies, home non-invasive ventilation (NIV). He has published 46 papers in high impact peer review journals, chapter author Australasian Sleep Medicine (2017) & co-authored professional guidelines. He is currently leading important collaborative research into the respiratory impact of neuromuscular diseases, physiological OSA traits and novel treatments for OSA.
In 1997 he established the UOWs WellSleep Sleep Investigation Centre and Research Group where as its director has fostered the training and careers of scientists, advanced trainee physicians and research students.
Recent professional achievements: American Thoracic Society Sleep & Respiratory Neurobiology Program Committee; President NZ Branch and Board Member Australasian Sleep Association; Inaugural board member NZ Sleep Health Foundation.
In his clinical role he works as a consultant physician providing clinical leadership for the Sleep and home NIV (175 patients) services across three regional DHBs.
Community-based non-invasive ventilation (NIV) as an effective treatment for chronic respiratory failure in neuromuscular disease
Community-based non-invasive ventilation (NIV) is an effective treatment for chronic respiratory failure that reduces hospitalisation, improves quality of life, the likelihood of maintaining employment, and, for some conditions survival.
I will present the results of research into the provision of home NIV in New Zealand with a focus on its use in neuromuscular diseases including Motor Neuron Disease (MND).
In a recent national survey we found the home-based NIV provision has almost doubled reflecting increased respiratory failure burden from COPD, OHS (disproportionately affecting Maori/ Pacific NZers) and neuromuscular disorders.
The number of people with Neuromuscular Diseases needing NIV has increased from 108 in 2012 to 175 in 2017. NIV dependency (use > 15 hours per day) was found in 4%. Concerns were raised by providers in terms of the funded staffing levels, safety, training of staff and carer and variable access to specialised equipment (battery back-up, back-up machines & cough assist) for NMDs. Large regional variation was found along with provider concerns highlighting the need improve health service provision particularly with regard to education and the provision of specialised equipment for neuromuscular conditions,
We are gaining valuable research insights from focus groups interviewing patients on NIV, their carers as well as New Zealand Clinicians (Otago research grant).
A recent ATS meeting allowed me to reflect on the provision of clinical services in NZ – during one of the key note addresses professional guideline were discussed & updated with new research. There are clearly still important research gaps – in particular with cough assist devices but some clinical consensus can be achieved.