- ICH GCP
- Registr klinických studií v USA
- Klinická studie NCT02509130
MISSION Severe Asthma Modern Innovative Solutions to Improve Outcomes in Severe Asthma. (MISSION)
MISSION Severe Asthma: Modern Innovative Solutions to Improve Outcomes in Severe Asthma. A Mixed Methods Observational Comparison of Clinical Outcomes in MISSION Versus Current Care Delivery.
Přehled studie
Postavení
Podmínky
Detailní popis
Purpose and design
The purpose of the study is to evaluate in detail the clinical and health economic outcomes from the MISSION project. The MISSION clinics combined a new way of delivering asthma care along with actively case finding patients who were not already known to specialist services but who had uncontrolled or at risk asthma.
The aim of the study is to compare the MISSION clinic model outcomes to current clinic model outcomes as well as performing qualitative interviews with patients who attended and staff who took part in the project.The research study was developed by a team from Portsmouth Hospital Trust and the University of Portsmouth including a research fellow, consultant and Professor, research methodologist, qualitative senior lecturer and independent statistician. A patient adviser also reviewed the lay summary and patient information sheets. The study undergoes independent review by another clinician as part of the sponsor process.
The study is also part of an MD project for the University of Portsmouth.
Design:
This is a mixed methods study.
A quantitative analysis of data from patients who attended the MISSION Rapid Access Asthma Clinics (RAAC), patients who attended the MISSION Severe Asthma Assessment Clinics (SAAC), patients who were invited to the RAAC but did not attend and patients who have been referred by their GP to the severe asthma clinic during the same time MISSION was running. The data analysis will include asthma control, hospital admissions, GP appointments, related medical conditions,medications, investigations and assessments done and time between appointments.
A qualitative study will be conducted using telephone interviews with patients who attended the SAAC and health care professionals who took part in the MISSION clinics.
The aim is to recruit:
- 44 MISSION patients (of whom 20 attended both the RAAC and the SAAC),
- 132 patients who were invited to MISSION RAAC but did not attend
- 20 patients referred to the severe asthma clinic at the hospital
- 20 health care professionals who took part in the MISSION clinics
Methodology:
Participants will be approached for consent by post. They will be given time to read the information and return the consent form to the study team. They will be given a contact number to discuss any questions.
Once a participant has consented to the quantitative study there is no further study procedures for the participant. Participants will be asked for consent to collect data from their GP and hospital records for the study. This will be entered onto a form (CRF) against a study number and then into a password protected study database held on a secure server at Portsmouth Hospitals NHS Trust. This data will then be analysed by a statistician and research fellow.
Participants for qualitative interview will have an interview over the telephone lasting 45 minutes to one hour. This will be recorded and transcribed. The participant will be given the transcript to read and correct. The transcripts will then be analysed looking for themes.
Typ studie
Zápis (Aktuální)
Kontakty a umístění
Studijní místa
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Hampshire
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Portsmouth, Hampshire, Spojené království, PO6 3LY
- Portsmouth Hospitals NHS Trust, Queen Alexandra Hospital
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Kritéria účasti
Kritéria způsobilosti
Věk způsobilý ke studiu
Přijímá zdravé dobrovolníky
Pohlaví způsobilá ke studiu
Metoda odběru vzorků
Studijní populace
Participants with uncontrolled or potentially severe asthma identified from GP records by the MISSION team and new referrals to an asthma specialist clinic at Queen Alexandra Hospital between May and August 2014.
Study participants for qualitative interview will be recruited from patients who attended MISSION SAAC days and staff who attended MISSION RAAC or SAAC days.
Popis
Inclusion Criteria:
- Male or Female, aged 18 years or above.
- Is in one of the following population groups:
- Attended the MISSION RAAC or
- Attended the MISSION SAAC or
- Identified as uncontrolled asthma by record searches and invited to MISSION RAAC but did not attend - 'primary care patients' or
- Has been referred to the specialist asthma clinic at Queen Alexandra Hospital - 'outpatient severe asthma patients' or
- Attended the MISSION RAAC or SAAC as a health care professional
- Participant is willing and able to give informed consent for participation in the study.
Exclusion Criteria:
- The patient is unable or unwilling to give consent
Studijní plán
Jak je studie koncipována?
Detaily designu
Kohorty a intervence
Skupina / kohorta |
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Patients who attended RAAC/SAAC.
Patients who have previously attended the Rapid Access Asthma Clinic (RAAC) will be approached for the quantitative study.
Patients who went onto the attend the Severe Asthma Assessment Clinics (SAAC) will also be approached for the quantitative and qualitive parts of the study.
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Patients eligible for RAAC, but DNA'd
Patients identified by the GP search, who did not attend the previous MISSION clinics will be approached to participate in the quantitative part of the study.
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Asthma Outpatients
Patients who are attending outpatient clinics as new referrals will be approached to participate in the quantitative part of the study.
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Healthcare Professionals
Healthcare professionals who performed the MISSION RAAC or SAAC will be approached for qualitative interview part of the study only.
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Co je měření studie?
Primární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
|---|---|---|
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Asthma control as measured by exacerbation frequency for all patients
Časové okno: 6 months
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The primary endpoint is asthma control as measured by exacerbation frequency (defined as deterioration in symptoms requiring ≥30mg prednisolone or equivalent for ≥3 days) for all patients
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6 months
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Sekundární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
|---|---|---|
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Short acting bronchodilator (SABA) use
Časové okno: 6 months
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Short acting bronchodilator (SABA) use measured by number of inhalers prescribed in 6 months pre and post MISSION SAAC, RAAC or outpatient clinic.
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6 months
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Exacerbation frequency
Časové okno: 6 months
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Exacerbation frequency (defined as deterioration in symptoms requiring ≥30mg prednisolone or equivalent for ≥3 days) in 6 months pre and post MISSION SAAC, RAAC or outpatient clinic.
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6 months
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Health care usage costs for asthma and number of contacts
Časové okno: 6 months
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Health care usage costs for asthma and number of contacts (GP visits, Emergency Department (ED) or out of hour attendances (OOH), hospital admissions, emergency GP visits) over 6 months pre and post MISSION or outpatient clinic.
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6 months
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Assessment of co-morbidity
Časové okno: 6 months
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Assessment of comorbidity (rhinosinusitis, anxiety and depression, dysfunctional breathing, gastro oesophageal reflux and obstructive sleep apnoea) and method of assessment for MISSION SAAC patients and outpatient severe asthma clinic patients
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6 months
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Assessment of inhaler technique and recommendations for inhaler devices.
Časové okno: 6 months
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Assessment of inhaler technique and recommendations for inhaler devices for MISSION SAAC patients and outpatient severe asthma clinic patients
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6 months
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Smoking cessation advice.
Časové okno: 6 months
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Smoking cessation advice for MISSION SAAC patients and outpatient severe asthma clinic patients
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6 months
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Investigations performed in secondary care
Časové okno: 6 months
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Investigations performed during 6 months in secondary care e.g.
full lung function, sputum induction, High-Resolution Computed Tomography (HRCT) chest for MISSION SAAC patients and outpatient severe asthma clinic patients
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6 months
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Time from GP referral to 1st clinic visit
Časové okno: 6 months
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Time from GP referral to 1st clinic visit in secondary care for MISSION SAAC patients and outpatient severe asthma clinic patients
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6 months
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Time between 1st and 2nd visit
Časové okno: 6 months
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Time between 1st and 2nd visit in secondary care for MISSION SAAC patients and outpatient severe asthma clinic patients
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6 months
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Time to appointment with other specialists
Časové okno: 6 months
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Time to appoint with other specialists for asthma related comorbidity where indicated, e.g.
dietician, Ear, Nose & Throat (ENT), physiotherapists, psychologist, CT imaging for MISSION SAAC patients and outpatient severe asthma clinic patients
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6 months
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Fractional Exhaled Nitric Oxide (FeNO) Assessment
Časové okno: 6 months
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Assessment of eosinophilic airways inflammation by FeNO for MISSION SAAC patients and outpatient severe asthma clinic patients
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6 months
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Frequency of non-attendance
Časové okno: 6 months
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The frequency of non-attendance at clinic for MISSION SAAC patients and outpatient severe asthma clinic patients
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6 months
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Severity of co-morbidities
Časové okno: 6 months
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Severity of co-morbidities for MISSION RAAC patients
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6 months
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Frequency of co-morbidities
Časové okno: 6 months
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Frequency of co-morbidities for MISSION RAAC patients
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6 months
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Frequency & type of allergy
Časové okno: 6 months
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Frequency & type of allergy for MISSION RAAC patients
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6 months
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Measurement of exhaled nitric oxide
Časové okno: 6 months
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Measurement of exhaled nitric oxide for MISSION RAAC patients
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6 months
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Measurement & variation of lung function (Single
Časové okno: 6 months
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Composite measurement & variation of lung function for MISSION RAAC patients
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6 months
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Frequency and type of additional asthma control medication.
Časové okno: 6 months
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Frequency and type of additional asthma control medication for MISSION RAAC patients
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6 months
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Quality of life
Časové okno: 6 months
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Quality of life as assessed by the Asthma Quality of Life Questionnaire (AQLQ).
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6 months
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Disease control
Časové okno: 6 months
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Disease control as assessed by the Asthma Control Questionnaire (ACQ)
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6 months
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Number of Forced Expiratory Volume at one second (FEV1) / Forced Vital Capacity (FVC) measurements
Časové okno: 6 months
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Number of patients having measurements of FEV1/FVC as a proxy for asthma control and severity in the MISSION RAAC patient and primary care patients
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6 months
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Prescription of SABA's
Časové okno: 6 months previous
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Prescription of Short Acting Bronchodilators (SABAs) during last 6 months at baseline and 6 months for MISSION RAAC and primary care patients.
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6 months previous
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Prescription of SABA's
Časové okno: Baseline
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Prescription of Short Acting Bronchodilators (SABAs) during last 6 months at baseline and 6 months for MISSION RAAC and primary care patients.
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Baseline
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Prescription of SABA's
Časové okno: 6 months
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Prescription of Short Acting Bronchodilators (SABAs) during last 6 months at baseline and 6 months for MISSION RAAC and primary care patients.
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6 months
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Exacerbation rates
Časové okno: 6 months previous
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Exacerbation rates (defined as deterioration in symptoms requiring ≥30mg prednisolone or equivalent for ≥3 days) during the last 6 months at baseline and 6 months for MISSION RAAC and primary care patients.
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6 months previous
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Exacerbation rates
Časové okno: Baseline
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Exacerbation rates (defined as deterioration in symptoms requiring ≥30mg prednisolone or equivalent for ≥3 days) during the last 6 months at baseline and 6 months for MISSION RAAC and primary care patients.
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Baseline
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Exacerbation rates
Časové okno: 6 months
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Exacerbation rates (defined as deterioration in symptoms requiring ≥30mg prednisolone or equivalent for ≥3 days) during the last 6 months at baseline and 6 months for MISSION RAAC and primary care patients.
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6 months
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ED attendances during the last 6 months
Časové okno: 6 months previous
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Emergency Department (ED) attendances during the last 6 months at baseline and 6 months for MISSION RAAC and primary care patients.
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6 months previous
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Out Of Hours (OOH) contacts during the last 6 months
Časové okno: 6 months previous
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Out Of Hours (OOH) contacts during the last 6 months at baseline and 6 months for MISSION RAAC and primary care patients.
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6 months previous
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Hospital admissions during the last 6 months
Časové okno: 6 months previous
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Emergency Department (ED) attendances, Out Of Hours (OOH) contacts and hospital admissions during the last 6 months at baseline and 6 months for MISSION RAAC and primary care patients.
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6 months previous
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ED attendances at baseline
Časové okno: Baseline
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Emergency Department (ED) attendances at baseline for MISSION RAAC and primary care patients.
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Baseline
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OOH contacts at baseline
Časové okno: Baseline
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Out Of Hours (OOH) contacts at baseline for MISSION RAAC and primary care patients.
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Baseline
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Hospital admissions at baseline
Časové okno: Baseline
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Hospital admissions at baseline for MISSION RAAC and primary care patients.
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Baseline
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ED attendances at 6 months.
Časové okno: 6 months
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Emergency Department (ED) attendances at 6 months for MISSION RAAC and primary care patients.
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6 months
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Out Of Hours (OOH) contacts at 6 months
Časové okno: 6 months
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Out Of Hours (OOH) contacts at 6 months for MISSION RAAC and primary care patients.
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6 months
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Hospital admissions during at 6 months
Časové okno: 6 months
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Hospital admissions during at 6 months for MISSION RAAC and primary care patients.
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6 months
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Inhaled steroid doses and usage
Časové okno: 6 months
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Inhaled steroid doses and usage for MISSION RAAC and primary care patients.
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6 months
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sensitivity and specificity of the Primary Care Information Services (PRIMIS) Asthma Audit Tool
Časové okno: 6 months
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The sensitivity and specificity of the PRIMIS Asthma Audit Tool in identifying the patients compared to gold standard specialist assessment and interrogation of primary care records for MISSION RAAC and primary care patients.
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6 months
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Spolupracovníci a vyšetřovatelé
Sponzor
Spolupracovníci
Vyšetřovatelé
- Vrchní vyšetřovatel: Professor Anoop J Chauhan, Portsmouth Hospitals NHS Trust
Publikace a užitečné odkazy
Obecné publikace
- Hoddinott P, Pill R. Qualitative research interviewing by general practitioners. A personal view of the opportunities and pitfalls. Fam Pract. 1997 Aug;14(4):307-12. doi: 10.1093/fampra/14.4.307.
- Hoddinott P, Pill R. A review of recently published qualitative research in general practice. More methodological questions than answers? Fam Pract. 1997 Aug;14(4):313-9. doi: 10.1093/fampra/14.4.313.
- Bulpitt H, Martin PJ. Who am I and what am I doing? Becoming a qualitative research interviewer. Nurse Res. 2010;17(3):7-16. doi: 10.7748/nr2010.04.17.3.7.c7741.
- Richards H, Emslie C. The 'doctor' or the 'girl from the University'? Considering the influence of professional roles on qualitative interviewing. Fam Pract. 2000 Feb;17(1):71-5. doi: 10.1093/fampra/17.1.71.
Termíny studijních záznamů
Hlavní termíny studia
Začátek studia
Primární dokončení (Aktuální)
Dokončení studie (Aktuální)
Termíny zápisu do studia
První předloženo
První předloženo, které splnilo kritéria kontroly kvality
První zveřejněno (Odhad)
Aktualizace studijních záznamů
Poslední zveřejněná aktualizace (Odhad)
Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality
Naposledy ověřeno
Více informací
Termíny související s touto studií
Klíčová slova
Další relevantní podmínky MeSH
Další identifikační čísla studie
- PHT/2015/15
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