Participatory Action Research to Evaluate the Delivery of the MISSION ABC Service Model and Assess Health Service and Clinical Outcomes

MISSION ABC: Modern Innovative Solutions to Improve Outcomes in Asthma, Breathlessness and COPD - Participatory Action Research to Evaluate the Delivery of the MISSION ABC Service Model and Assess Health Service and Clinical Outcomes

Innovations aimed at improving new patient identification, diagnosis, nonpharmacological treatment, supported self-management, and remote monitoring, together with new methods of clinical support could improve outcomes in patients with respiratory disease. The Investigators have developed a model of care incorporating key innovations for patients with asthma, COPD and undifferentiated breathlessness. This service is being implemented within Wessex CCGs. The investigators will assess whether the implementation of the service is effective, and how it can be adjusted, in addition to introducing innovations to assess whether the expected benefits for patients are realised.

A combination of study designs are required to evaluate all aspects of the service:

• Participatory action research approach, involving real-time evaluation at each clinic to inform subsequent clinics
• Before-and-after study for patient outcomes pre-clinic attendance and post-clinic attendance.
• Qualitative methods (interviews, focus groups)

Evaluation of the clinic cycles will include consideration of qualitative data from patients, carers and healthcare professionals, in addition to quantitative outcomes for service implementation and patient factors (i.e. uptake of the service and benefits realised in-session), including those in the following areas:

• Clinic process
• Education and supported self-management
• Added value of diagnostic tools (new diagnoses)
• Applicability and use of treatment tools and treatment tailoring
• Self-monitoring appropriateness and uptake
• Balance measures (e.g. increased secondary care traffic)

The longer-term impact of the service will be evaluated using clinical and health service outcomes such as:

• Hospitalisations for airways disease
• perceived disease control (symptom scores etc)
• exacerbation frequency
• health-related quality of life
• Patient Activation Measures (PAM)
• Treatments used
• Healthcare resource use (primary and secondary care)

Inclusion Criteria:

• Attendance at a MISSION ABC clinic or training session as a patient, carer or Healthcare Professional

Exclusion Criteria:

• Unable to give informed consent
• Level of literacy precludes inclusion in questionnaire-based study