Quantitative and Qualitative Evaluation of a Service Development Programme for Patients with Severe Asthma:
: MISSION Asthma

  • Claire Amy Roberts

Student thesis: Doctoral Thesis

Abstract

Asthma that is poorly controlled and undertreated can progress to more severe disease that is associated with high levels of unscheduled care and reduction in quality of life.
Objective: This study aimed to evaluate a new service model for uncontrolled asthma and compare clinical outcomes with standard care.
Methods: MISSION Asthma was a novel clinic model that identified patients with poorly controlled disease who were not under secondary care in 5 GP surgeries in Hampshire in 2016. Patients then attended a single group, multi-disciplinary clinic – Rapid Access Asthma Clinic (RAAC) and those identified as having potentially severe asthma went on to a one-day severe asthma assessment clinic (SAAC). The clinical outcomes of measure of asthma control in the MISSION group were compared to control groups from GP and outpatient cohorts.
Qualitative interviews were held with patients attending the SAAC and health care professionals.
Results: Eighty-three patients consented to take part, with data available for eighty-two. Six took part in the qualitative study. Five health care professionals consented to qualitative interview. The study did not meet the primary outcome measure of comparing SAAC patients with standard care due to low numbers in the outpatient comparison group. The secondary outcome was to assess the asthma control of MISSION RAAC versus GP patients. There was no significant difference in these groups at 6 months. In patients who attended the MISSION asthma clinics, there was a clinically significant improvement in asthma control and quality of life at three months and in asthma control at six months (p<0.05). The healthcare utilisation costs of the MISSION patients decreased significantly in the six months after the clinic, with a mean reduction of £124 per patient. There were six broad themes identified in the interviews: asthma knowledge, experience of the multi-disciplinary team in asthma care, previous experience of asthma care, MISSION experience, experiences of living with asthma and the importance of communication.
Conclusions: The study included only small numbers of patients therefore conclusions are limited. For the small number included, the MISSION asthma project showed a reduction in healthcare utilisation costs and improvement in asthma control. The qualitative study suggested the clinic model was acceptable to both patients and staff.
Date of Award17 Oct 2023
Original languageEnglish
Awarding Institution
  • University of Portsmouth
SupervisorRebecca Stores (Supervisor), Karen Elizabeth Pilkington (Supervisor) & Anoop Chauhan (Supervisor)

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