None listed
Conditions
Brief summary
The BREATHE FAST study (Breathlessness Rapid Evaluation And THErapy – Fast Assessment Spirometry Testing) aims to improve the early and accurate diagnosis of chronic obstructive pulmonary disease (COPD) in rural and regional general practice. It will use a self-administered digital screening questionnaire for breathlessness and a point-of-care micro-spirometry test (FAST) performed within the practice to support general practitioners (GPs) in identifying and managing patients with chronic breathlessness. Each practice will participate for 3-6 months. The study will assess the benefits for patients and GPs in terms of case detection of COPD. The BREATHE FAST system will • Identify patients with chronic breathlessness through a short digital questionnaire completed on their phone or tablet and provide results directly into the GP software ahead of the consultation. • Enable practice nurses or GPs to perform a Fast Assessment Spirometry Test (FAST) using a simple handheld device to detect a lung condition called chronic obstructive lung disease (COPD). We hypothesise that this approach will provide clinicians with timely, objective information prior to and during the consultation, improving the case detection of COPD.
Interventions
This patient self-screening and micro-spirometry intervention (BREATHE FAST) will be implemented for 6 months in each practice, and practices will commence the intervention in a staged rollout. Data will be collected across pre-intervention and intervention periods using automated software to extract de-identified patient demographics, clinical diagnoses, and COPD-related data. Retrospective data will be collected once using each practices' auditing software (e.g. POLAR, PenCS) from the prior 1
This patient self-screening and micro-spirometry intervention (BREATHE FAST) will be implemented for 6 months in each practice, and practices will commence the intervention in a staged rollout. Data will be collected across pre-intervention and intervention periods using automated software to extract de-identified patient demographics, clinical diagnoses, and COPD-related data. Retrospective data will be collected once using each practices' auditing software (e.g. POLAR, PenCS) from the prior 12 months to the BREATHE intervention to establish baseline diagnosis rates, while data for the duration of the intervention period will to extracted once at completion to assess changes. Patients will complete dyspnoea self-screening in the 24 hours prior to their GP consultation on their smartphone- this screening item will be sent using software that collects pre-consultation information from patients (BetterConsult software). Dyspnoea self-screening will take 1-2 minutes to complete. Patients with a modified Medical Research Council (mMRC) score of 1 or higher who have been symptomatic for 4 or more weeks will be identified as being at risk for COPD and will be invited to perform micro-spirometry when they attend their GP practice for their appointment. Micro-spirometry involves the patient sitting upright, inhaling completely, and sealing their lips around a mouthpiece. The patient must blow out as hard, fast, and long as possible (at least 6 seconds) until the lungs are empty. This is repeat 3 times to ensure the best estimate. GPs and practice nurses will receive training from either a GP or respiratory physician in Fast Assessment Spirometry Testing (FAST) one week prior to the commencement of the intervention to identify airflow obstruction in patients with chronic dyspnoea using a standard care handheld micro-spirometer, with an FEV1/FEV6 ratio <0.76 indicative of possible COPD. FAST assessment will take approximately 5 minutes to complete per patient and patients will only be invited for FAST once. The results of the patient FAST assessment will be recorded in the patient electronic medical record. Additionally, a qualitative process evaluation will be conducted in nine diverse practices through semi-structured interviews with staff and patients to explore implementation experiences.
Sponsors
The University of Notre Dame Australia
Study design
Allocation
Non-randomised trial
Intervention model
Other
Primary purpose
Diagnosis
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
General Practices • Use Best Practice software General Practitioners • Provide written informed consent to participate. Patients • Aged 18years or older. • Consent to SMS communication with their GP practice
Exclusion criteria
None
Outcome results
None listed