COPD Clinical Trial
Official title:
The Impact of Specialist Led Integrated Care on Guideline Adherence and Outcomes in COPD
This study will look at the impact of care delivery by a specialist respiratory doctor compared to general practitioners for patients with COPD in East Birmingham. The primary outcome will be to compare the rates of provision of guideline-based care in intervention and control practices.
This study will look at the impact of care delivery by a specialist respiratory doctor
compared to general practitioners for patients with COPD in East Birmingham. It will be run
from the Heart of England NHS Foundation Trust, which will provide the specialist input and
oversight, and up to 40 practices across the Eastern Birmingham Health Organisation with
approximately 2200 patients with COPD confirmed by their current medical practitioner. Each
practice will be randomised to either the intervention or control group. The intervention
group will have their usual annual COPD review performed by a specialist respiratory doctor
at baseline and 12 months. The patients will receive care using our local COPD guidance which
has been accepted by all local commissioning groups and secondary care organisations.
Treatment will be at the discretion of the clinician and is not specified in the trial
protocol. The investigators anticipate that the treatment recommendations in the intervention
arm may include referral to pulmonary rehabilitation and reduction in the use of inhaled
corticosteroids, which are prescribed at high rates in our locality. The control group will
be seen by the usual staff at their practice. These patients will not be seen by the trial
team and their data will be extracted remotely using electronic systems.
The primary outcome will be to compare the rates of provision of guideline-based care in
intervention and control practices. Secondary outcomes will include: referral to secondary
care, unscheduled healthcare consultations (ED attendance, hospital admissions), COPD
exacerbations, healthcare costs, medications prescribed, biochemical markers of disease,
radiological investigations, lung function tests measured when clinically indicated, and
death within 12 month follow-up period.
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