Abstract
BackgroundAsthma that is poorly controlled and undertreated can progress to more severe disease that is associated with high levels of unscheduled care that requires high-cost therapy, leading to a significant health economic burden. The identification and appropriate referral to a specialist asthma service is also often delayed by several months or years because of poor recognition and understanding of symptom severity. Current severe asthma services may take several months to provide a comprehensive multidisciplinary assessment, often necessitating multiple hospital visits and costing up to £5000 per patient.ObjectiveThis study aims to evaluate whether a new service model could identify poorly controlled and potentially severe asthma much earlier in the patient pathway, and then compare clinical outcomes between this new care model with standard care.MethodsModern Innovative Solutions to Improve Outcomes in (MISSION) Severe Asthma is a novel service model developed by asthma specialists from Portsmouth and Southampton severe asthma services. MISSION Severe Asthma identified patients with poorly controlled disease from general practice databases who had not been under secondary outpatient care in the last 12 months or who were not known to secondary care. In 1- or 2-stop assessments, a thorough review of diagnosis, disease phenotype, and control is undertaken, and clinical outcomes collected at baseline.ResultsA variety of clinical outcomes will be collected to assess the service model. The results will be reported in February 2020.ConclusionsThis protocol outlines a mixed methods study to assess the impact on disease control, unscheduled health care usage, and quality of life in patients seen in the MISSION clinic compared with a closely matched cohort who declined to attend.International Registered Report Identifier (IRRID)DERR1-10.2196/9585
Highlights
Background and RationaleThe Burden of DiseaseAsthma affects 5.4 million patients in the United Kingdom with the majority of costs relating to treating poorly controlled asthma, amounting to over £1 billion per annum as a direct cost and an indirect cost to society of £6 billion
Modern Innovative Solutions to Improve Outcomes in (MISSION) Severe Asthma identified patients with poorly controlled disease from general practice (GP) databases who had not been under secondary outpatient care in the last 12 months or who were not known to secondary care
Using quantitative and qualitative methods, our objective is to explore the impact of the MISSION service on clinical outcomes and patient experience
Summary
Background and RationaleThe Burden of DiseaseAsthma affects 5.4 million patients in the United Kingdom with the majority of costs (nearly 80%) relating to treating poorly controlled asthma, amounting to over £1 billion per annum as a direct cost and an indirect cost to society (time off work and lost productivity) of £6 billion. The Outcome Strategy for Chronic Obstructive Pulmonary Disease and Asthma recognized this huge burden on both patients and the National Health Service (NHS) and outlined the political commitment to improve asthma control and reduce asthma-related emergency health care needs and deaths [3]. Objective: This study aims to evaluate whether a new service model could identify poorly controlled and potentially severe asthma much earlier in the patient pathway, and compare clinical outcomes between this new care model with standard care. Conclusions: This protocol outlines a mixed methods study to assess the impact on disease control, unscheduled health care usage, and quality of life in patients seen in the MISSION clinic compared with a closely matched cohort who declined to attend.
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