JMIR Publications

ABSTRACT

COPD is the second leading cause of death in the UK and accounts for 1.7% of bed days in acute hospitals. An estimated 2/3 patients with COPD remain undiagnosed. MISSION COPD aimed to proactively identify patients from primary care who were undiagnosed or uncontrolled and deliver a comprehensive integrated multidisciplinary clinic to address the needs of this complex group to improve diagnosis, personalise therapy and empower patients to self manage. This clinic was led by a Respiratory Specialist team from Portsmouth Hospitals NHS trust working with five Primary Care surgeries in Wessex. 108 patients were seen, with 98 consenting to be followed up for research. Diagnoses were changed in 14 patients and 32 new diagnoses were made. Reductions were seen across all aspects of unscheduled care compared to each participants use in the 12 months prior: emergency GP visits (3.37-0.79 per patient, p=<0.01), exacerbations (2.64-0.56 per patient, p=0.01), out-of-hours calls (0.16-0.05 per patient, p=0.423), hospital admissions (0.49-0.12 per patient, p=0.48). Improvements were seen in quality of life and symptom scores in addition to patient activation (PAM) and patient reported confidence. This pilot has demonstrated the MISSION model may be an effective way to provide comprehensive gold-standard care that is valued by patients and promotes integration across sectors.