CompletedInterventional

Pragmatic evaluation of a quality improvement programme for people living with modifiable high-risk chronic obstructive pulmonary disease

Chronic Obstructive Pulmonary Disease (COPD) causes breathlessness, wheezing, and frequent chest flare-ups. Many people live with COPD without a formal diagnosis, while others do not receive the most effective inhalers to protect their lungs. This study evaluates a quality improvement programme in English GP practices to help doctors identify patients aged 40 and older who are at high risk of worsening symptoms. Half of the participating surgeries will receive training and digital tools to review records and update care. The other half will continue providing their usual high standard of care. Because researchers study anonymised information already recorded in electronic GP files, patients do not need to attend extra hospital visits or take experimental drugs. Over three years, researchers will measure whether this proactive approach reduces emergency chest troubles, protects lung health, and improves daily quality of life.

At a glance

Status

Completed

Sponsor

Observational & Pragmatic Research Institute

Enrolment target

2,016

Start

07 Mar 2022

Estimated completion

31 Oct 2022

Chronic Obstructive Pulmonary Disease (COPD)

What is this study about?

Chronic Obstructive Pulmonary Disease (COPD) is a long-term lung condition that makes it hard to breathe. It develops slowly over many years, often causing a stubborn cough, chest tightness, and wheezing. Sadly, many people adapt to their symptoms and do not realise they have a lung condition until they suffer a severe chest infection or flare-up. Even among people who have a diagnosis, many are not taking the most up-to-date medications that prevent long-term lung damage.

This study is testing a quality improvement programme designed to help primary care teams bridge this gap. Participating GP surgeries in England are randomly placed into one of two groups. One group receives dedicated support and digital decision-making tools to review patient records. These tools help doctors find people who may have unrecognised COPD, as well as those with diagnosed COPD who keep having chest flare-ups despite their current treatments. The other group continues with their standard care as normal.

By comparing both groups over three years, researchers hope to see if this guided review helps doctors prescribe more suitable inhalers and offer lifestyle support, such as pulmonary rehabilitation classes or help to quit smoking. Finding and managing high-risk COPD earlier could mean fewer emergency hospital visits, slower loss of lung function, and a much better quality of life for thousands of patients across the UK.

Key takeaways

Tests a new programme to help GP surgeries in England spot and treat high-risk COPD.
Aims to reduce chest flare-ups, protect lung health, and prevent hospital visits.
Uses anonymised medical records, requiring no extra tests, blood draws, or trial appointments.
All treatment decisions remain strictly between you and your normal healthcare team.
Runs over three years to evaluate long-term improvements in patient care.

Who may be eligible?

This study takes place at the GP practice level, meaning whole surgeries sign up rather than individual patients. Surgeries across England can join if they have enough patients aged 40 or older who might benefit from better COPD management.

Within participating surgeries, the programme looks at two groups of patients. The first group includes people aged 40 and older who already have a COPD diagnosis and have had at least two moderate flare-ups (or one severe flare-up requiring hospital care) in the past two years, while taking only basic or limited inhalers.

The second group includes people aged 40 and older who do not have a COPD diagnosis, but who have smoked for at least 10 years, have had repeated chest flare-ups, and may be using short-acting inhalers. Surgeries that are currently changing their computer systems or already taking part in similar COPD programmes cannot participate.

Could this study suit you?

Answer these quick questions to see if you may be eligible. This is a guide only — the research team makes the final call.

You are registered with a participating GP surgery in England.
You are aged 40 or older.
You have diagnosed COPD and have had chest flare-ups over the last two years.
Alternatively, you have a 10-year history of smoking, repeated chest troubles, but no formal diagnosis yet.
You currently use only basic inhalers or are not on regular preventive lung medication.

Answer every question to see your result.

What does participation involve?

Taking part in this study requires very little effort from patients. Because it is a records-based study, you do not need to travel to special research centres, undergo experimental tests, or take untrialled medications. Your GP surgery will be involved for around three years. During this time, the study team looks at anonymised health data pulled directly from electronic GP records. If your GP practice is using the new programme and identifies that your chest could be better managed, your own doctor or practice nurse will invite you for a routine review. They will discuss your symptoms and work with you to update your inhalers or refer you to helpful services, just like they would during standard NHS care.

Potential risks and benefits

The main benefit of this study is that it helps doctors spot hidden lung problems sooner and ensure people are on the best inhalers to stop chest flare-ups. Patients may also be offered support to stop smoking or referred to breathing exercise programmes. Because the study only reviews existing medical records and follows normal NHS guidelines, there are no extra physical risks or experimental drugs involved. Any change to your care is decided safely between you and your doctor. You always have the right to opt out of having your health records shared for research by speaking to your GP practice.

Locations (1)

Some site locations are approximate. We're improving this — please verify with the trial team before travelling.

Observational and Pragmatic Research International Ltd
City only
Norwich, England

Common questions

Do I have to attend extra clinic visits for this study?

No. The study gathers information directly from your normal GP computer records, so you will not need to attend any extra research appointments.

Will my inhalers be changed without my permission?

No. Any changes to your medication will be discussed and agreed upon with your GP or practice nurse during a normal clinical review.

How is my personal medical data protected?

All information collected from GP records is completely anonymised before it reaches the research team. Your name, address, and personal identifiers are removed.

What happens if my GP practice is in the usual care group?

Your surgery will continue to provide standard NHS care. Surgeries in the usual care group will be offered the quality improvement programme once the study ends.

Can I opt out if I do not want my records included?

Yes. You can contact your GP surgery at any time to register for the national data opt-out, which stops your anonymised records from being used in research.

How to find out more

Andy Dickens

andydickens@opri.sg +44 (0)1223 967855 Official trial record

Always speak to your GP or specialist before deciding to take part in a study.