A stepped-wedge cluster randomized trial of a virtual ward programme for patients with acute exacerbations of COPD: the BRIDGE study
Chronic obstructive pulmonary disease (COPD)
New service incorporating virtual wards (the intervention) versus the usual care system with no virtual ward care (the control) for patients with COPD experiencing an acute exacerbation. This is virtual ward system that is going to be rolled out to COPD patients in the Birmingham area regardless of whether this study goes ahead. All GP practices in the study area (n=178) will serve as the clusters, which will be randomised to one of eleven trial sequences that will serve as the basis to expand eligibility to the intervention to patients in a random, staggered order between December 2025 and April 2027. The random roll out order will be generated using covariate constrained randomisation scheme run by an independent statistician and then implemented by the service provider who will determine eligibility at the point of patient referral.
All patients on the COPD register for each GP in the catchment area for the data analysis will be included in the study. The intervention is being rolled out in all GPs in BCHC so there are no other inclusion criteria.
There are no exclusion criteria for either clusters or individuals. However, we provide a mechanism for patients to withdraw access to their data on request.