Developing, refining and piloting a practical intervention
(HELP-COPD)
Chronic obstructive pulmonary disease (COPD) is a potentially serious long-term lung disease. Over 90,000 people in Scotland are living with COPD. People with very severe COPD have a recognised burden of disabling physical symptoms (especially breathlessness) often compounded by psychological distress and social isolation. Standard models of care to help and support people with chronic conditions are often designed for cancer patients and are less helpful for people with COPD. Building on our previous work, published in the British Medical Journal (Pinnock et al. BMJ 2011; 342:d142), the HELP-COPD project aims to develop, refine, and then pilot a new approach to providing supportive help for people with COPD. This new approach will be built around the HELP-COPD action plan.
The proposed HELP-COPD action plan: Initial ideas
The proposed design of the HELP-COPD action plan is a single page document, designed to prompt and structure a discussion between a health professional and a patient with COPD. Its use is triggered by an admission to hospital with an acute exacerbation of COPD. The document will prompt discussion about physical, psychological, social, spiritual and other needs (if any) and, when completed with a health professional, is designed to provide an action plan to manage and track possible actions/referrals. The action plan will be held by the patient, and copied to any relevant health professionals such as the patient's GP and any referral agencies.
The project timeline
There are three phases to this programme of work.
- An initial 'modelling' phase. We wish to interview around 20 key individuals, both patients and health professionals, about the proposed design of the HELP-COPD action plan.
- A 'refining' phase. A few patients will be invited to try the HELP-COPD action plan. Both patients and professionals (including GPs of the participating patients and administrative staff involved with handling referrals) will be asked to explain about their experience of the action plan, and how they feel its design can be refined and improved.
- A 'pilot randomised controlled trial'. We will randomly assign 40 patients to either the 'usual care' group (who will not have any change to their usual care) or the 'intervention' group (who will work through the HELP-COPD action plan with our research nurse) and will compare the impact on quality of life and the services received.
The project will be conducted with help from the Royal Infirmary of Edinburgh respiratory ward, and will be complete by January 2014.
Research paper
This study is now complete. A journal article discussing the results can be found here: HELPing older people with very severe chronic obstructive pulmonary disease (HELP-COPD): mixed-method feasibility pilot randomised controlled trial of a novel intervention
Very many thanks to all our study participants.