MISSION ABC: transforming respiratory care through one-stop multidisciplinary clinics – an observational study

MISSION ABC: transforming respiratory care through one-stop multidisciplinary clinics – an observational study

ObjectivesThe 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....

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Published in:BMJ open Vol. 14; no. 1; p. e078947
Main Authors: Heiden, Emily, Longstaff, Jayne, Chauhan, Milan J A, DeVos, Ruth, Lanning, Ellie, Neville, Daniel, Jones, Thomas Llewelyn, Begum, Selina, Amos, Mark, Mottershaw, Mark, Micklam, Joanne, Holdsworth, Ben, Rupani, Hitasha, Brown, Thomas, Chauhan, Anoop J, Baghammar, Jona, Bannell, Kathryn, Dominey, Rachel, Guile, Robert, Jackson, Richard, Leung, Anthony, Maxwell, Fiona, Meehan, Dave, Moseley, Sara, Pullen, Marcus, Rickard, Kathleen A, Sanders, Mark, Whiteman, Matt
Format: Journal Article
Language:English
Published: England British Medical Journal Publishing Group 08-01-2024
BMJ Publishing Group LTD
BMJ Publishing Group
Series:Original research
Subjects:
Adult
Ambulatory Care Facilities
Asthma
Asthma - therapy
Chronic obstructive pulmonary disease
Clinics
Cost analysis
Dyspnea
General Practitioners
Health care access
Health services utilization
Humans
Inhalers
Medical referrals
Observational studies
Participatory research
Patient Participation
Patients
Primary care
Primary Health Care
Productivity
Prospective Studies
Pulmonary Disease, Chronic Obstructive
Pulmonary Disease, Chronic Obstructive - therapy
Quality of Life
Questionnaires
Respiratory Medicine
United Kingdom > UK
Primary Health Care
Patient Participation
Pulmonary Disease, Chronic Obstructive
Asthma
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Summary:ObjectivesThe 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.DesignThis study used a prospective, longitudinal, participatory action research approach.SettingThe study was conducted in primary care practices across Hampshire, UK.ParticipantsAdults aged 16 years and above with poorly controlled asthma or COPD, as well as those with undifferentiated breathlessness not under specialist care, were included.InterventionsParticipants received care through the multidisciplinary, specialist-led MABC clinics.Primary and secondary outcome measuresPrimary 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.ResultsA 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.ConclusionsSpecialist-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 numberNCT03096509.
Bibliography:Original research
ObjectType-Article-2
SourceType-Scholarly Journals-1
ObjectType-Undefined-1
ObjectType-Feature-3
content type line 23
ISSN:2044-6055
2044-6055
DOI:10.1136/bmjopen-2023-078947