TY  - JOUR
AU  - Lanning, Eleanor
AU  - Longstaff, Jayne
AU  - Jones, Thomas
AU  - Roberts, Claire
AU  - Neville, Daniel
AU  - DeVos, Ruth
AU  - Storrar, Will
AU  - Green, Ben
AU  - Brown, Thomas
AU  - Leung, Anthony
AU  - Fogg, Carole
AU  - Dominey, Rachel
AU  - Bassett, Paul
AU  - Meredith, Paul
AU  - Chauhan, Anoop J
PY  - 2019
DA  - 2019/10/1
TI  - Modern Innovative Solutions in Improving Outcomes in Chronic Obstructive Pulmonary Disease (MISSION COPD): Mixed Methods Evaluation of a Novel Integrated Care Clinic
JO  - Interact J Med Res
SP  - e9637
VL  - 8
IS  - 4
KW  - chronic obstructive pulmonary disease
KW  - comorbidity
KW  - multidisciplinary
KW  - delivery of health care
KW  - diagnosis
AB  - 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. 
SN  - 1929-073X
UR  - https://www.i-jmr.org/2019/4/e9637
UR  - https://doi.org/10.2196/ijmr.9637
UR  - http://www.ncbi.nlm.nih.gov/pubmed/31573894
DO  - 10.2196/ijmr.9637
ID  - info:doi/10.2196/ijmr.9637
ER  -