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Pulmonary Disease, Chronic ObstructiveMISSION-COPDNCT02534766

MISSION COPD - Modern Innovative SolutionS in Improving Outcomes iN COPD

An observational study of Pulmonary Disease, Chronic Obstructive, run by Portsmouth Hospitals NHS Trust at 1 site in United Kingdom.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

MISSION is a new and novel way of delivering highly specialised Chronic Obstructive Pulmonary Disease (COPD) care and has the potential to change the way COPD care across the UK is delivered as well as services for other long term health conditions. Read more about this study

Who is it for?
Ages 18 years and olderHealthy volunteers can take part
Conditions the study is for
Pulmonary Disease, Chronic Obstructive
How many people
114 participants
Where
1 siteUnited Kingdom
Study dates
Sep 2015to Aug 2016
Phase
Observational
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Study population: Participants will be 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 or health care professionals who attend the clinic in a clinical capacity.

Who may be able to join

  • 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.
  • 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.

Who cannot join

  • The patient is unable or unwilling to give consent
  • The health care professional is unable or unwilling to give consent

Trial locations and contacts

1 site in 1 country.

United Kingdom1 site
  • Portsmouth Hospitals NHS Trust, Queen Alexandra Hospital

    Portsmouth, Hampshire, PO6 3LY

Other trials in United Kingdom

About this study

Official title: MISSION COPD - Modern Innovative SolutionS in Improving Outcomes iN - COPD - A Comparison of Clinical Outcomes Before and After the MISSION Clinic.

MISSION is a new and novel way of delivering highly specialised Chronic Obstructive Pulmonary Disease (COPD) care and has the potential to change the way COPD care across the UK is delivered as well as services for other long term health conditions. The MISSION model has been piloted in asthma which is the subject of an ongoing research study. This is the first model of this type in COPD and the current research study aims to evaluate the outcomes of the project. This will be done in several different ways. The study is a mixed methods evaluation of the new service comparing outcomes before and after the clinic using retrospective data analysis and prospective qualitative interview. The study will be conducted at Portsmouth Hospitals NHS Trust and will recruit patients who attend MISSION COPD clinics as well as staff who attended MISSION clinics in a professional capacity.

Read the detailed description

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.

Medical subject headings
Pulmonary Disease, Chronic Obstructive

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

Study groups in NCT02534766
Study groupRoleWhat they receive
Patients who attended the MISSION COPD clinicsCOPD 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 ProfessionalsHealth Care Professionals who attended the MISSION COPD clinics in a professional/ clinical capacity.

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. COPD control measured by number of exacerbations treated with steroids and or antibiotics for ≥3 days

    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.

    Measured: 6 months previous

  2. COPD control measured by number of exacerbations treated with steroids and or antibiotics for ≥3 days

    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.

    Measured: 6 months

  3. Number of exacerbations of COPD that require hospital admission and treatment

    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

    Measured: 6 months previous

  4. Number of exacerbations of COPD that require hospital admission and treatment

    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

    Measured: 6 months

Secondary outcomes (38)
  1. COPD Assessment Test (CAT) Score

    patients will complete the CAT questionnaire to assess COPD control

    Measured: baseline

  2. COPD Assessment Test (CAT) Score

    patients will complete the CAT questionnaire to assess COPD control

    Measured: 3 months

  3. COPD Assessment Test (CAT) Score

    patients will complete the CAT questionnaire to assess COPD control

    Measured: 6 months

  4. St George's Respiratory Questionnaire (SGRQ)

    Measured: baseline

  5. St George's Respiratory Questionnaire (SGRQ)

    Measured: 3 months

  6. St George's Respiratory Questionnaire (SGRQ)

    Measured: 6 months

  7. Number of non elective GP visits for COPD

    Number of non elective GP visits for COPD in the 6 months pre MISSION

    Measured: 6 month previous

  8. Number of non elective GP visits for COPD

    Number of non elective GP visits for COPD in the 6 months post MISSION

    Measured: 6 months

  9. Number of hospital admissions for COPD

    Number of hospital admissions for COPD in the 6 months pre MISSION

    Measured: 6 month previous

  10. Number of hospital admissions for COPD

    Number of hospital admissions for COPD in the 6 months post MISSION

    Measured: 6 months

  11. Number of Emergency Department contacts for COPD

    Number of Emergency Department contacts for COPD in the 6 months pre MISSION

    Measured: 6 month previous

  12. Number of Emergency Department contacts for COPD

    Number of Emergency Department contacts for COPD in the 6 months post MISSION

    Measured: 6 months

  13. Number of out of hour (OOH) attendances/contacts for COPD

    Number of out of hour attendances (OOH) contacts for COPD in the 6 months pre MISSION

    Measured: 6 month previous

  14. Number of out of hour (OOH) attendances/contacts for COPD

    Number of out of hour attendances (OOH) contacts for COPD in the 6 months post MISSION

    Measured: 6 months

  15. Global initiative in chronic Obstructive Lung Disease (GOLD) score

    To assess the severity of COPD by GOLD and BTS stage in the MISSION clinics

    Measured: Baseline

  16. Measurement and variation of lung function.

    Measured: Baseline

  17. Assessment of eosinophilic airways inflammation

    Assessment of eosinophilic airways inflammation by Fractional Exhaled Nitric Oxide (FeNO) Assessment.

    Measured: Baseline

  18. COPD controller medication

    COPD controller medication in 6 months pre MISSION.

    Measured: 6 months previous

  19. COPD controller medication

    COPD controller medication in 6 months post MISSION.

    Measured: 6 months

  20. Number of antibiotic courses without prednisolone for lower respiratory tract infections

    Number of antibiotic courses without prednisolone for lower respiratory tract infections in 6 months pre MISSION

    Measured: 6 months previous

  21. Number of antibiotic courses without prednisolone for lower respiratory tract infections

    Number of antibiotic courses without prednisolone for lower respiratory tract infections in 6 months post MISSION

    Measured: 6 months

  22. Short acting bronchodilator (SABA) use

    Short acting bronchodilator (SABA) use measured by number of inhalers prescribed in 6 months pre MISSION.

    Measured: 6 months previous

  23. Short acting bronchodilator (SABA) use

    Short acting bronchodilator (SABA) use measured by number of inhalers prescribed in 6 months post MISSION.

    Measured: 6 months

  24. Frequency and severity of co-morbidities

    Frequency and severity of co morbidities including anxiety and depression, dysfunctional breathing, gastro oesophageal reflux and obstructive sleep apnoea in all patients.

    Measured: Baseline

  25. Medication adherence

    Medication adherence will be measured at baseline

    Measured: Baseline

  26. Medication adherence

    Medication adherence will be measured at 3 months

    Measured: 3 months

  27. Medication adherence

    Medication adherence will be measured at 6 months

    Measured: 6 months

  28. Patient activation measure

    Patients will complete the patient activation measure questionnaire at Baseline

    Measured: Baseline

  29. Patient activation measure

    Patients will complete the patient activation measure questionnaire at 3 months

    Measured: 3 months

  30. Patient activation measure

    Patients will complete the patient activation measure questionnaire at 6 months

    Measured: 6 months

  31. Investigations performed

    Investigations performed at the MISSION COPD clinics (e.g. sputum induction, High-Resolution Computed Tomography (HRCT) chest).

    Measured: Baseline

  32. Hospital Anxiety and Depression Scale (HADS) score

    HADS scores at baseline for patients attending the MISSION clinics

    Measured: Baseline

  33. Hospital Anxiety and Depression Scale (HADS) score

    HADS scores at 6 months for patients attending the MISSION clinics

    Measured: 6 months

  34. Gastroesophageal Reflux Disease Questionnaire (GERDQ) score

    GERDQ scores at baseline for patients attending the Severe COPD Assessment Clinic (SCAC)

    Measured: baseline

  35. Gastroesophageal Reflux Disease Questionnaire (GERDQ) score

    GERDQ scores at 6 months for patients attending the Severe COPD Assessment Clinic (SCAC)

    Measured: 6 months

  36. Assessment of inhaler technique and recommendations for inhaler devices.

    Measured: Baseline

  37. Smoking cessation advice

    Measured: Baseline

  38. The frequency of non-attendance at clinic

    The frequency of non-attendance at the MISSION clinic

    Measured: Baseline

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted28 Aug 2015 (estimated)
  2. Study startSep 2015
  3. Primary completionAug 2016
  4. Study completionAug 2016

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Retrospective
Enrolment
114 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02534766
Sponsor's protocol ID
PHT/2015/71
Acronym
MISSION-COPD
Status last verified
Sep 2016
First submitted
25 Aug 2015
Last updated
27 Sep 2016
Results posted
No
Data monitoring committee
No

Publications

  • 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.

    PubMed 24108523
  • 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.

    PubMed 25141877

Questions about this trial

What is this clinical trial studying?

An observational study of Pulmonary Disease, Chronic Obstructive, run by Portsmouth Hospitals NHS Trust at 1 site in United Kingdom.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 6 inclusion and 2 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 27 Sep 2016. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United Kingdom. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

COPD control measured by number of exacerbations treated with steroids and or antibiotics for ≥3 days (time frame: 6 months previous). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02534766, which also lists 2 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 27 Sep 2016.

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