- ICH GCP
- Yhdysvaltain kliinisten tutkimusten rekisteri
- Kliininen tutkimus NCT02534766
MISSION COPD - Modern Innovative SolutionS in Improving Outcomes iN COPD (MISSION-COPD)
MISSION COPD - Modern Innovative SolutionS in Improving Outcomes iN - COPD - A Comparison of Clinical Outcomes Before and After the MISSION Clinic.
Tutkimuksen yleiskatsaus
Tila
Yksityiskohtainen kuvaus
The purpose of the study is to evaluate in detail the clinical and health economic outcomes from the MISSION COPD project. MISSION COPD is a quality improvement project funded by the Health Foundation, Foundation with additional funding from Pfizer, to trial an innovative way of finding and assessing patients with COPD and also case finding new diagnoses of COPD.
MISSION-COPD will allow swift early specialist multi-disciplinary interventions in primary care to diagnose and treat those at greatest risk, consistent with the NHS England '5-year Forward View' calling for removal of traditional primary and secondary care barriers. MISSION COPD will target COPD patients with risk factors for exacerbations and deteriorating lung function as well potential new diagnoses of COPD.
The aim of the study is to review the MISSION clinic model outcomes as well as performing qualitative interviews with patients who attended and staff who took part in the project.
Up to 150 patients who attend the MISSION COPD clinic will be recruited along with approximately 20 health care professionals. The number of patients has been decided as the number that can be seen for the project in the MISSION COPD project time and budget.
Participants will be either:
- Patients who attend MISSION COPD clinics - identified as having uncontrolled or potentially severe COPD or unrecognised COPD from GP records by the MISSION clinical team
- Health care professionals who attend the clinic in a clinical capacity.
Retrospective quantitative analysis of the data collected during the MISSION clinics will be analysed looking for COPD phenotypes and contributing co-morbidities. The data collected at the initial visit and 3 and 6 month follow up questionnaires will be analysed looking for improvement in COPD control and quality of life following the patients' attendance at MISSION clinics.
A self completion questionnaire will be filled in after the clinic by participants in the research study to assess their views on the clinic and where they would like changes to be made. A questionnaire will also be given to health care professionals to seek their views on the clinic.
Qualitative interviews will be conducted with a sample of participants, willing to take part, to explore the experiences and acceptability of the participants and health care professionals. The interviews with health care professionals will explore their thoughts on MISSION and its strengths and weaknesses as well as any suggestions for improvement.
This research is important as it will provide evidence to support the use of the MISSION clinic model for patients with COPD. It will also give us more information on the patient with COPD and any medical conditions related to their COPD so we can adapt our service to meet their needs.
The telephone and group interviews will help us understand what we are doing right and what we are doing wrong with COPD care.
Opintotyyppi
Ilmoittautuminen (Todellinen)
Yhteystiedot ja paikat
Opiskelupaikat
-
-
Hampshire
-
Portsmouth, Hampshire, Yhdistynyt kuningaskunta, PO6 3LY
- Portsmouth Hospitals NHS Trust, Queen Alexandra Hospital
-
-
Osallistumiskriteerit
Kelpoisuusvaatimukset
Opintokelpoiset iät
Hyväksyy terveitä vapaaehtoisia
Sukupuolet, jotka voivat opiskella
Näytteenottomenetelmä
Tutkimusväestö
Kuvaus
Inclusion Criteria - Patients:
- Male of Female, aged 18 years or above.
- Attended the MISSION clinic as a patient.
- Participant is willing and able to give informed consent for participation in the study.
Exclusion Criteria - Patients:
- The patient is unable or unwilling to give consent
Inclusion criteria - Health Care Professionals
- Male or Female, aged 18 or above.
- Attended the MISSION clinic as a health care professional
- Participant is willing and able to give informed consent for participation in the study.
Exclusion Criteria - Health Care Professionals
- The health care professional is unable or unwilling to give consent
Opintosuunnitelma
Miten tutkimus on suunniteltu?
Suunnittelun yksityiskohdat
Kohortit ja interventiot
Ryhmä/Kohortti |
---|
Patients who attended the MISSION COPD clinics
COPD patients who attended the MISSION COPD clinics, identified as having uncontrolled or potentially severe COPD or unrecognised COPD from GP records by the MISSION clinical team
|
Health Care Professionals
Health Care Professionals who attended the MISSION COPD clinics in a professional/ clinical capacity.
|
Mitä tutkimuksessa mitataan?
Ensisijaiset tulostoimenpiteet
Tulosmittaus |
Toimenpiteen kuvaus |
Aikaikkuna |
---|---|---|
COPD control measured by number of exacerbations treated with steroids and or antibiotics for ≥3 days
Aikaikkuna: 6 months previous
|
To assess whether the number COPD exacerbations (prednisolone or equivalent ≥30 mg for >3 days or antibiotics for >3 days) improves in MISSION patients in the 6 months after the clinic compared with the 6 months before.
|
6 months previous
|
COPD control measured by number of exacerbations treated with steroids and or antibiotics for ≥3 days
Aikaikkuna: 6 months
|
To assess whether the number COPD exacerbations (prednisolone or equivalent ≥30 mg for >3 days or antibiotics for >3 days) improves in MISSION patients in the 6 months after the clinic compared with the 6 months before.
|
6 months
|
Number of exacerbations of COPD that require hospital admission and treatment
Aikaikkuna: 6 months previous
|
Number of exacerbations of COPD that require admission to hospital for treatment to assess whether hospital admissions change in the 6 months after the MISSION clinic
|
6 months previous
|
Number of exacerbations of COPD that require hospital admission and treatment
Aikaikkuna: 6 months
|
Number of exacerbations of COPD that require admission to hospital for treatment to assess whether hospital admissions change in the 6 months after the MISSION clinic
|
6 months
|
Toissijaiset tulostoimenpiteet
Tulosmittaus |
Toimenpiteen kuvaus |
Aikaikkuna |
---|---|---|
COPD Assessment Test (CAT) Score
Aikaikkuna: baseline
|
patients will complete the CAT questionnaire to assess COPD control
|
baseline
|
COPD Assessment Test (CAT) Score
Aikaikkuna: 3 months
|
patients will complete the CAT questionnaire to assess COPD control
|
3 months
|
COPD Assessment Test (CAT) Score
Aikaikkuna: 6 months
|
patients will complete the CAT questionnaire to assess COPD control
|
6 months
|
St George's Respiratory Questionnaire (SGRQ)
Aikaikkuna: baseline
|
baseline
|
|
St George's Respiratory Questionnaire (SGRQ)
Aikaikkuna: 3 months
|
3 months
|
|
St George's Respiratory Questionnaire (SGRQ)
Aikaikkuna: 6 months
|
6 months
|
|
Number of non elective GP visits for COPD
Aikaikkuna: 6 month previous
|
Number of non elective GP visits for COPD in the 6 months pre MISSION
|
6 month previous
|
Number of non elective GP visits for COPD
Aikaikkuna: 6 months
|
Number of non elective GP visits for COPD in the 6 months post MISSION
|
6 months
|
Number of hospital admissions for COPD
Aikaikkuna: 6 month previous
|
Number of hospital admissions for COPD in the 6 months pre MISSION
|
6 month previous
|
Number of hospital admissions for COPD
Aikaikkuna: 6 months
|
Number of hospital admissions for COPD in the 6 months post MISSION
|
6 months
|
Number of Emergency Department contacts for COPD
Aikaikkuna: 6 month previous
|
Number of Emergency Department contacts for COPD in the 6 months pre MISSION
|
6 month previous
|
Number of Emergency Department contacts for COPD
Aikaikkuna: 6 months
|
Number of Emergency Department contacts for COPD in the 6 months post MISSION
|
6 months
|
Number of out of hour (OOH) attendances/contacts for COPD
Aikaikkuna: 6 month previous
|
Number of out of hour attendances (OOH) contacts for COPD in the 6 months pre MISSION
|
6 month previous
|
Number of out of hour (OOH) attendances/contacts for COPD
Aikaikkuna: 6 months
|
Number of out of hour attendances (OOH) contacts for COPD in the 6 months post MISSION
|
6 months
|
Global initiative in chronic Obstructive Lung Disease (GOLD) score
Aikaikkuna: Baseline
|
To assess the severity of COPD by GOLD and BTS stage in the MISSION clinics
|
Baseline
|
Measurement and variation of lung function.
Aikaikkuna: Baseline
|
Baseline
|
|
Assessment of eosinophilic airways inflammation
Aikaikkuna: Baseline
|
Assessment of eosinophilic airways inflammation by Fractional Exhaled Nitric Oxide (FeNO) Assessment.
|
Baseline
|
COPD controller medication
Aikaikkuna: 6 months previous
|
COPD controller medication in 6 months pre MISSION.
|
6 months previous
|
COPD controller medication
Aikaikkuna: 6 months
|
COPD controller medication in 6 months post MISSION.
|
6 months
|
Number of antibiotic courses without prednisolone for lower respiratory tract infections
Aikaikkuna: 6 months previous
|
Number of antibiotic courses without prednisolone for lower respiratory tract infections in 6 months pre MISSION
|
6 months previous
|
Number of antibiotic courses without prednisolone for lower respiratory tract infections
Aikaikkuna: 6 months
|
Number of antibiotic courses without prednisolone for lower respiratory tract infections in 6 months post MISSION
|
6 months
|
Short acting bronchodilator (SABA) use
Aikaikkuna: 6 months previous
|
Short acting bronchodilator (SABA) use measured by number of inhalers prescribed in 6 months pre MISSION.
|
6 months previous
|
Short acting bronchodilator (SABA) use
Aikaikkuna: 6 months
|
Short acting bronchodilator (SABA) use measured by number of inhalers prescribed in 6 months post MISSION.
|
6 months
|
Frequency and severity of co-morbidities
Aikaikkuna: Baseline
|
Frequency and severity of co morbidities including anxiety and depression, dysfunctional breathing, gastro oesophageal reflux and obstructive sleep apnoea in all patients.
|
Baseline
|
Medication adherence
Aikaikkuna: Baseline
|
Medication adherence will be measured at baseline
|
Baseline
|
Medication adherence
Aikaikkuna: 3 months
|
Medication adherence will be measured at 3 months
|
3 months
|
Medication adherence
Aikaikkuna: 6 months
|
Medication adherence will be measured at 6 months
|
6 months
|
Patient activation measure
Aikaikkuna: Baseline
|
Patients will complete the patient activation measure questionnaire at Baseline
|
Baseline
|
Patient activation measure
Aikaikkuna: 3 months
|
Patients will complete the patient activation measure questionnaire at 3 months
|
3 months
|
Patient activation measure
Aikaikkuna: 6 months
|
Patients will complete the patient activation measure questionnaire at 6 months
|
6 months
|
Investigations performed
Aikaikkuna: Baseline
|
Investigations performed at the MISSION COPD clinics (e.g.
sputum induction, High-Resolution Computed Tomography (HRCT) chest).
|
Baseline
|
Hospital Anxiety and Depression Scale (HADS) score
Aikaikkuna: Baseline
|
HADS scores at baseline for patients attending the MISSION clinics
|
Baseline
|
Hospital Anxiety and Depression Scale (HADS) score
Aikaikkuna: 6 months
|
HADS scores at 6 months for patients attending the MISSION clinics
|
6 months
|
Gastroesophageal Reflux Disease Questionnaire (GERDQ) score
Aikaikkuna: baseline
|
GERDQ scores at baseline for patients attending the Severe COPD Assessment Clinic (SCAC)
|
baseline
|
Gastroesophageal Reflux Disease Questionnaire (GERDQ) score
Aikaikkuna: 6 months
|
GERDQ scores at 6 months for patients attending the Severe COPD Assessment Clinic (SCAC)
|
6 months
|
Assessment of inhaler technique and recommendations for inhaler devices.
Aikaikkuna: Baseline
|
Baseline
|
|
Smoking cessation advice
Aikaikkuna: Baseline
|
Baseline
|
|
The frequency of non-attendance at clinic
Aikaikkuna: Baseline
|
The frequency of non-attendance at the MISSION clinic
|
Baseline
|
Yhteistyökumppanit ja tutkijat
Sponsori
Yhteistyökumppanit
Tutkijat
- Päätutkija: Professor Anoop J Chauhan, Portsmouth Hospitals NHS Trust
Julkaisuja ja hyödyllisiä linkkejä
Yleiset julkaisut
- Kruis AL, Smidt N, Assendelft WJ, Gussekloo J, Boland MR, Rutten-van Molken M, Chavannes NH. Integrated disease management interventions for patients with chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2013 Oct 10;(10):CD009437. doi: 10.1002/14651858.CD009437.pub2.
- Wilkinson T, North M, Bourne SC. Reducing hospital admissions and improving the diagnosis of COPD in Southampton City: methods and results of a 12-month service improvement project. NPJ Prim Care Respir Med. 2014 Aug 21;24(0):14035. doi: 10.1038/npjpcrm.2014.35.
Opintojen ennätyspäivät
Opi tärkeimmät päivämäärät
Opiskelun aloitus
Ensisijainen valmistuminen (Todellinen)
Opintojen valmistuminen (Todellinen)
Opintoihin ilmoittautumispäivät
Ensimmäinen lähetetty
Ensimmäinen toimitettu, joka täytti QC-kriteerit
Ensimmäinen Lähetetty (Arvio)
Tutkimustietojen päivitykset
Viimeisin päivitys julkaistu (Arvio)
Viimeisin lähetetty päivitys, joka täytti QC-kriteerit
Viimeksi vahvistettu
Lisää tietoa
Tähän tutkimukseen liittyvät termit
Muita asiaankuuluvia MeSH-ehtoja
Muut tutkimustunnusnumerot
- PHT/2015/71
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