Medical Research

What are your research interests?

• High-flow oxygen therapy as an alternative to standard nasal prong oxygen in paediatrics. We have just completed the first trial of high-flow oxygen in children 
• Improved care for babies and young children with bronchiolitis as a result of showing that high-flow oxygen is safe and effective for use in children’s wards
• Understanding and describing complex pain in childhood to improve access to children’s pain services. (Kepreotes & Lord, 2017, in publication)
• The social impacts of rare diseases of childhood as experienced by parents and those who support the families
• Furthering our understanding of connective tissue disorders of childhood that lead to complex pain conditions

Why did you get into research?

There are always questions that need answers. It is difficult to make safe, sustained changes in healthcare without research to guide clinical decision-making. People may think that a certain practice is better but often the apparent benefit is overestimated, so where possible, a clinical trial should be done. I also think that clinical research needs to capture the views of parents and children to really understand the impact of a proposed practice. Even in clinical trials, consumer opinion is vital. 

What would be the ultimate goal for your research?

I would love to see clinical improvements in the way that we deliver oxygen to children, how we support families where a child or young adult is living with complex pain, and in the early diagnosis and management of moderate to severe hypermobility (flexibility of joints) in children to reduce the likelihood of carrying pain into adult years. 

Biography

Dr Elizabeth Kepreotes is a Clinical Nurse Consultant at the John Hunter Children’s Hospital, Newcastle and a Conjoint Senior Lecturer with the University of Newcastle’s School of Nursing and Midwifery. Dr Kepreotes and her team have just completed the first clinical trial of high-flow oxygen in children, which has now been published in The Lancet. This study, with its novel procedures for starting and weaning oxygen, and responding to clinical deterioration in babies with bronchiolitis, has the potential to increase the safety and effectiveness of supplemental oxygen delivery in acute paediatric respiratory conditions - http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)30061-2/fulltext

Dr Kepreotes was awarded the  University of Newcastle Faculty of Health with the Research Higher Degree Excellence Award in 2015 for her PhD research. Her study used critical ethnography to examine the experience of parenting a child with a diagnosed rare disease in order to identify the factors that help or hinder parents in their adjustment to that unexpected role. Since many rare diseases feature pain as a daily feature, which perhaps has the most serious consequences for a family, Dr Kepreotes joined a Children’s Complex Pain Service in 2013 to further her work in this area. She has noted that a disproportionally high number of children and young people with complex pain have very flexible bodies, so understanding any association between pain and hypermobility is of great interest to the team.

Future Focus

• Improving the care of babies and young children with bronchiolitis by being able to predict those who are most at risk of developing severe/life-threatening bronchiolitis and therefore most in need of intensive care therapies
• Examining whether critical care high-flow oxygen is safe and effective in ward–based populations to test whether an earlier intervention may reduce the need for transfer to intensive care

Specialised/Technical Skills 

• Qualitative methods
• Clinical trial design
• Ethical considerations when working with children and parents
• Qualitative interviews

Affiliations

• Hunter Medical Research Institute, VIVA Program
• University of Newcastle, Priority Research Centre GrowUpWell
• Thoracic Society of Australia and New Zealand
• Australian Pain Society