@Article{info:doi/10.2196/ijmr.9637,
author="Lanning, Eleanor
and Longstaff, Jayne
and Jones, Thomas
and Roberts, Claire
and Neville, Daniel
and DeVos, Ruth
and Storrar, Will
and Green, Ben
and Brown, Thomas
and Leung, Anthony
and Fogg, Carole
and Dominey, Rachel
and Bassett, Paul
and Meredith, Paul
and Chauhan, Anoop J",
title="Modern Innovative Solutions in Improving Outcomes in Chronic Obstructive Pulmonary Disease (MISSION COPD): Mixed Methods Evaluation of a Novel Integrated Care Clinic",
journal="Interact J Med Res",
year="2019",
month="Oct",
day="1",
volume="8",
number="4",
pages="e9637",
keywords="chronic obstructive pulmonary disease; comorbidity; multidisciplinary; delivery of health care; diagnosis",
abstract="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. ",
issn="1929-073X",
doi="10.2196/ijmr.9637",
url="https://www.i-jmr.org/2019/4/e9637",
url="https://doi.org/10.2196/ijmr.9637",
url="http://www.ncbi.nlm.nih.gov/pubmed/31573894"
}