TY - JOUR
T1 - MISSION ABC
T2 - Transforming respiratory care through one-stop multidisciplinary clinics - an observational study
AU - Mission ABC Collaborators
AU - Heiden, Emily
AU - Longstaff, Jayne
AU - Chauhan, Milan J. A.
AU - Devos, Ruth
AU - Lanning, Ellie
AU - Neville, Daniel
AU - Jones, Thomas Llewelyn
AU - Begum, Selina
AU - Amos, Mark
AU - Mottershaw, Mark
AU - Micklam, Joanne
AU - Holdsworth, Ben
AU - Rupani, Hitasha
AU - Brown, Thomas
AU - Chauhan, Anoop J.
N1 - Funding Information:
This study was funded by Portsmouth Hospitals NHS Trust sponsorship (PHT/2016/84), Pfizer's medical grant (WP1307188/WP1592862), Wessex Academic Health Science Network and East Hampshire Better Local Care Fund with project support from Robert Guile and Fiona Maxwell (RHU-G-000700390), The Health Foundation (spread and adoption website) (Ref 7749), Circassia Equipment Grant and the Wessex CRN (service support).
Publisher Copyright:
© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
PY - 2024/1/8
Y1 - 2024/1/8
N2 - Objectives: The Modern Innovative Solutions to Improve Outcomes in Asthma, Breathlessness and Chronic Obstructive Pulmonary Disease (COPD) (MABC) service aimed to enhance disease management for chronic respiratory conditions through specialist multidisciplinary clinics, predominantly in the community. This study assesses the outcomes of these clinics. Design: This study used a prospective, longitudinal, participatory action research approach. Setting: The study was conducted in primary care practices across Hampshire, UK. Participants: Adults aged 16 years and above with poorly controlled asthma or COPD, as well as those with undifferentiated breathlessness not under specialist care, were included. Interventions: Participants received care through the multidisciplinary, specialist-led MABC clinics. Primary and secondary outcome measures: Primary outcomes included disease activity, quality of life and healthcare utilisation. Secondary outcomes encompassed clinic attendance, diagnostic changes, patient activation, participant and healthcare professional experiences and cost-effectiveness. Results: A total of 441 participants from 11 general practitioner practices were recruited. Ninety-six per cent of participants would recommend MABC clinics. MABC assessments led to diagnosis changes for 64 (17%) participants with asthma and COPD and treatment adjustments for 252 participants (57%). Exacerbations decreased significantly from 236 to 30 after attending the clinics (p<0.005), with a mean reduction of 0.53 exacerbation events per participant. Reductions were also seen in unscheduled and out-of-hours primary care attendance, emergency department visits and hospital admissions (all p<0.005). Cost savings from reduced exacerbations and healthcare utilisation offset increased medication costs and clinic expenses. Conclusions: Specialist-supported multidisciplinary teams in MABC clinics improved diagnosis accuracy and adherence to guidelines. High patient satisfaction, disease control improvements and reduced exacerbations resulted in decreased unscheduled healthcare use and cost savings. Trial registration number NCT03096509.
AB - Objectives: The Modern Innovative Solutions to Improve Outcomes in Asthma, Breathlessness and Chronic Obstructive Pulmonary Disease (COPD) (MABC) service aimed to enhance disease management for chronic respiratory conditions through specialist multidisciplinary clinics, predominantly in the community. This study assesses the outcomes of these clinics. Design: This study used a prospective, longitudinal, participatory action research approach. Setting: The study was conducted in primary care practices across Hampshire, UK. Participants: Adults aged 16 years and above with poorly controlled asthma or COPD, as well as those with undifferentiated breathlessness not under specialist care, were included. Interventions: Participants received care through the multidisciplinary, specialist-led MABC clinics. Primary and secondary outcome measures: Primary outcomes included disease activity, quality of life and healthcare utilisation. Secondary outcomes encompassed clinic attendance, diagnostic changes, patient activation, participant and healthcare professional experiences and cost-effectiveness. Results: A total of 441 participants from 11 general practitioner practices were recruited. Ninety-six per cent of participants would recommend MABC clinics. MABC assessments led to diagnosis changes for 64 (17%) participants with asthma and COPD and treatment adjustments for 252 participants (57%). Exacerbations decreased significantly from 236 to 30 after attending the clinics (p<0.005), with a mean reduction of 0.53 exacerbation events per participant. Reductions were also seen in unscheduled and out-of-hours primary care attendance, emergency department visits and hospital admissions (all p<0.005). Cost savings from reduced exacerbations and healthcare utilisation offset increased medication costs and clinic expenses. Conclusions: Specialist-supported multidisciplinary teams in MABC clinics improved diagnosis accuracy and adherence to guidelines. High patient satisfaction, disease control improvements and reduced exacerbations resulted in decreased unscheduled healthcare use and cost savings. Trial registration number NCT03096509.
KW - asthma
KW - patient participation
KW - primary health care
KW - pulmonary disease, chronic obstructive
UR - http://www.scopus.com/inward/record.url?scp=85181996315&partnerID=8YFLogxK
U2 - 10.1136/bmjopen-2023-078947
DO - 10.1136/bmjopen-2023-078947
M3 - Article
C2 - 38191248
AN - SCOPUS:85181996315
SN - 2044-6055
VL - 14
JO - BMJ Open
JF - BMJ Open
IS - 1
M1 - e078947
ER -