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Pragmatic Evaluation of an Improvement Programme for People Living with Modifiable High-risk COPD.

PREVAIL, will be the first efficacy trial to assess clinical outcomes of the CONQUEST quality improvement and clinical decision support package versus standard care for patients with modifiable high-risk chronic obstructive pulmonary disease with or without a current diagnosis.

The study will assess a programme called CONQUEST. This is a new way to find, diagnose and improve treatment for patients with a lung condition known as COPD or may be at risk of developing this condition.

PREVAIL will enrol 126 GP practices to take part. Half of practices will receive the CONQUEST programme and the other half will continue with their usual patient care.

Identifying high-risk patients with COPD, including those who are undiagnosed

Helping patients to receive a timely assessment of their COPD

Support implementation of the best available treatment in line with national and local guidance

Review of current management plans

WHY ARE WE DOING THIS RESEARCH?

Chronic obstructive pulmonary disease (COPD) is a condition that affects over 250 million people world-wide. Many people with COPD, including those that have not been diagnosed yet, experience breathing problems and other symptoms which sometimes get suddenly worse, known as an exacerbation or flare-up. Appropriate treatment can help improve the health of these patients and reduce the exacerbations they experience.

CONQUEST is a new quality improvement programme developed by doctors and health experts to help practices identify and manage modifiable high-risk COPD patients according to current guidelines (GOLD, NICE) to help reduce exacerbations and improve clinical outcomes in these patients.

PREVAIL is a study that will be assessing how effective the CONQUEST programme is at improving treatment and reducing exacerbations in diagnosed and undiagnosed patients with modifiable high-risk COPD.

BENEFITS FOR YOUR PRACTICE

  • Ongoing education, training, support, monitoring and improvement

  • Package embedded within practice processes and care pathways

  • Decrease in practice-patient contacts and improved patient experience

  • Facilitators will help practices with the implementation

BENEFITS FOR YOUR PATIENTS

Patients will receive assessments of individual risk and biological traits to drive optimal management and follow up And this will benefit your patients through:

  • Improving rates of smoking cessation, flu/pneumococcal vaccination and self-management.

  • Improving assessment and treatment, reducing steroid and antibiotics burden.

  • Optimising treatment that will lead to a reduction in exacerbations and rate of lung function decline, whilst improving COPD control and quality of life.

ABOUT CONQUEST QI PROGRAMME

CONQUEST aims to close the gaps in current COPD care and what current guidelines recommend by driving EARLY identification of HIGH-RISK PATIENTS and targeted, risk-based treatment with the patient at the centre.

This quality improvement programme will help drive change in the management of patients at risk of COPD exacerbations by imbedding quality standards in routine primary care. The programme will be provided at no cost to participating practices by Optimum Patient Care Quality Improvement Service.

WHO IS CONDUCTING AND FUNDING THE STUDY?

The PREVAIL study is led by Dr Katherine Hickman (Chief Investigator, GP partner in Bradford, Respiratory Lead for West Yorkshire and Harrogate, Primary Care Respiratory Society) and Professor David B. Price (Professor of Primary Care Respiratory Medicine - University of Aberdeen, European Respiratory Society). This research is run by the Observational and Pragmatic Research International Limited (OPRI). The research is funded by Optimum Patient Care Global Limited and Astrazeneca.

HOW TO JOIN PREVAIL?

If you are a GP practice in England and you wish to take part in PREVAIL, please contact us: Tel: 01223 967855 Email: engage@optimumpatientcare.org We are currently receiving expressions of interest from practices. The study is planned to begin in the autumn of 2021 following NHS research ethics approval.

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