Shared medical appointments in primary care for improving self-management of chronic obstructive pulmonary disease amongst underserved groups: a feasibility randomized control trial in North East and North Cumbria
Chronic obstructive pulmonary disease
Participants will be randomly allocated to attend a shared appointment in-person or by video link, or receive usual care. The researchers will: 1. Measure the number of patients that take part and remain in the study 2. Interview patients about experiences in the study 3. Test how to collect information from patients about NHS use 4. Interview staff about how well shared appointments work 5. Test how to collect information about the time and money needed to run SMAs 6. Use their findings to decide if a larger trial is possible A number generator will be used to randomize the patients in a ratio of 1:1:1 to either the in-person SMA arm, video SMA arm or usual care arm of the trial using variable length random permuted blocks within strata. Participants randomized to the treatment arms will attend a single, 90-minute shared medical appointment delivered by a team of staff from participating primary care practices. Participants allocated to receive usual care (control arm) will receive no additional intervention. Usual care typically includes an annual review delivered 1:1 in person, pulmonary rehabilitation (if appropriate) and primary and secondary care treatment for exacerbations. Primary care visits tend to be 1:1 appointments with the nurse practitioner/ pharmacist that last 10-15 minutes. It is also possible that they may be referred, or self-refer, to attend a 1:1 appointment with a social prescribing link-worker. Follow-up will occur approximately 6 months from baseline (3 months post intervention) and again at 12 months from baseline (9 months post intervention.) This will involve the completion of study questionnaires either hard copies returned by free post, over the telephone with the research team or via online form. A sample of participants will be invited to participate in a 1:1 qualitative interview with the research team to explore their views and experiences of the SMA and study processes. This will take place within approximately 8 weeks of t
1. Aged 18 years or older with a diagnosis of COPD 2. Under ongoing management in general practice 3. Able to give informed consent
1. Without the capacity to consent i.e., with dementia or significant learning difficulties 2. With severe mental ill-health 3. Requiring palliative care 4. Diagnosed with a condition likely to limit life expectancy to <1 year