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Accepted for/Published in: Interactive Journal of Medical Research

Date Submitted: Dec 13, 2017
Open Peer Review Period: Dec 13, 2017 - Jun 21, 2018
Date Accepted: Jun 21, 2018
(closed for review but you can still tweet)

The final, peer-reviewed published version of this preprint can be found here:

Modern Innovative Solutions in Improving Outcomes in Chronic Obstructive Pulmonary Disease (MISSION COPD): Mixed Methods Evaluation of a Novel Integrated Care Clinic

Lanning E, Longstaff J, Jones T, Roberts C, Neville D, DeVos R, Storrar W, Green B, Brown T, Leung A, Fogg C, Dominey R, Bassett P, Meredith P, Chauhan AJ

Modern Innovative Solutions in Improving Outcomes in Chronic Obstructive Pulmonary Disease (MISSION COPD): Mixed Methods Evaluation of a Novel Integrated Care Clinic

Interact J Med Res 2019;8(4):e9637

DOI: 10.2196/ijmr.9637

PMID: 31573894

PMCID: 6774234

Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.

Modern Innovative Solutions in Improving Outcomes in Chronic Obstructive Pulmonary Disease (MISSION COPD): Mixed Methods Evaluation of a Novel Integrated Care Clinic

  • Eleanor Lanning; 
  • Jayne Longstaff; 
  • Thomas Jones; 
  • Claire Roberts; 
  • Daniel Neville; 
  • Ruth DeVos; 
  • Will Storrar; 
  • Ben Green; 
  • Thomas Brown; 
  • Anthony Leung; 
  • Carole Fogg; 
  • Rachel Dominey; 
  • Paul Bassett; 
  • Paul Meredith; 
  • Anoop J Chauhan

Background:

Chronic obstructive pulmonary disease (COPD) is the second-leading cause of death in the United Kingdom and accounts for 1.7% of bed days in acute hospitals. An estimated two-third of patients with COPD remain undiagnosed.

Objective:

Modern Innovative Solutions in Improving Outcomes in Chronic Obstructive Pulmonary Disease (MISSION COPD) aimed to proactively identify patients from primary care who were undiagnosed or had uncontrolled COPD and to provide a comprehensive integrated multidisciplinary clinic to address the needs of this complex group for improving diagnosis, personalizing therapy, and empowering patients to self-manage their condition.

Methods:

This clinic was led by a respiratory specialist team from Portsmouth Hospitals NHS Trust working with five primary care surgeries in Wessex. A total of 108 patients were reviewed, with 98 patients consenting to provide additional data for research. Diagnoses were changed in 14 patients, and 32 new diagnoses were made.

Results:

Reductions were seen across all aspects of unscheduled care as compared to the prior 12 months, including in emergency general practitioner visits (3.37-0.79 visits per patient, P<.001), exacerbations (2.64-0.56 per patient, P=.01), out-of-hours calls (0.16-0.05 per patient, P=.42), and hospital admissions (0.49-0.12 per patient, P=.48). Improvements were observed in the quality of life and symptom scores in addition to patient activation and patient-reported confidence levels.

Conclusions:

This pilot demonstrates that the MISSION model may be an effective way to provide comprehensive gold-standard care that is valued by patients and to promote integration across sectors.


 Citation

Please cite as:

Lanning E, Longstaff J, Jones T, Roberts C, Neville D, DeVos R, Storrar W, Green B, Brown T, Leung A, Fogg C, Dominey R, Bassett P, Meredith P, Chauhan AJ

Modern Innovative Solutions in Improving Outcomes in Chronic Obstructive Pulmonary Disease (MISSION COPD): Mixed Methods Evaluation of a Novel Integrated Care Clinic

Interact J Med Res 2019;8(4):e9637

DOI: 10.2196/ijmr.9637

PMID: 31573894

PMCID: 6774234

Per the author's request the PDF is not available.

© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.