Chronic respiratory disease: asthma, bronchiectasis, interstitial lung disease, sleep apnoea Respiratory
Conditions
Interventions
This is a mixed methods analysis of real-world clinical practice aimed at determining the important factors for the design and delivery of optimal integrated respiratory services.
The study will com
Sponsors
University of Birmingham
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: Objective 2: 1. Patients will be those identified in the primary research study (INTEGR COPD) as having an admission(s) to hospital due to AECOPD or respiratory illness during the primary study follow up period. Objective 3: 1. Healthcare Professionals (Practice Nurses, General Practitioners, Respiratory Physicians, Resident Doctors, Healthcare Assistants, Paramedics, Advanced Clinical Practitioners, Pharmacists, Physician Associates, Physiotherapists) working within respiratory integrated services (or have been within the last 12 months) 2. Staff member (non-clinical) involvement in the organisation/delivery/commissioning of integrated respiratory services (or have been within the last 12 months) 3. Respiratory specialist trainees currently holding a respiratory national training number in the UK, respiratory specialist doctors, respiratory associate specialists (or have been within the last 12 months) 4. Trainee and qualified allied health professionals currently working (or have been within the last 12 months) within respiratory services in the UK (This is expected to include, but may not be exclusively, the following professional groups nursing, physiotherapy, occupational therapy, pharmacy, dietetics, speech and language therapy, clinical scientist, physiologists) Objective 4: The following groups will be eligible to participate in semi-structured interviews: 1. Healthcare Professionals (Practice Nurses, General Practitioners, Resident Doctors, Healthcare Assistants, Paramedics, Advanced Clinical Practitioners, Pharmacists, Physician Associates, Physiotherapists) and administrative staff members at GP practice sites within the Birmingham and Solihull Integrated Care Board (BSol ICB) either currently in post or who have been in post within the last 12 months 2. Secondary care respiratory service staff at University Hospitals Birmingham NHS Trust (covering Queen Elizabeth Hospital Birmingham, Birmingham Heartlands Hospital and Good Hope Hospital) either currently in post or who have been in post within the last 12 months (Participants will likely include Respiratory Consultants, Specialist Respiratory Trainees, Resident Doctors, Specialist Respiratory Nurses, Physiotherapists, Occupational Therapists, Pharmacists, Advanced Clinical Practitioners, Respiratory Physiologists) 3. BSol Integrated Care Board staff contributing to respiratory services either currently in post or who have been in post within the last 12 months (Participants will likely include Respiratory Consultants, Specialist Respiratory Trainees, GPs, Specialist Respiratory Nurses, Physiotherapists, Occupational Therapists, Pharmacists, Advanced Clinical Practitioners, respiratory physiologists and administrators) 4. Patients accessing BSol ICB integrated respiratory services within the study period
Exclusion criteria
Exclusion criteria: Objective 3: 1. Not a member of clinical or operational staff in an integrated respiratory service within the last 12 months 2. Not involved in organisation/delivery/commissioning of integrated respiratory services within the last 12 months 3. Unable to consent Objective 4: 1. Healthcare Professional - Not a member of BSol ICB catchment area services 2. Patient – not reviewed by the BSol ICB integrated respiratory service 3. Unable to consent
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Objective 2: Admission episodes in control and intervention groups within the follow-up period of the INTEGR COPD study will be reviewed. The following factors will be measured and the relationship between individual admission factors will be compared between intervention and control groups using both descriptive statistics and multivariate analyses: 1. Reason for admission 2. Location of admission 3. Length of stay 4. Number and type of comorbidities (respiratory, cardiac, psychiatric, other) 5. Any indication of access to integrated/community services prior/post admission. 6. Discharge destination 7. Smoking status 8. Ethnicity Objective 3: Healthcare professional attitudes on the following areas of respiratory integrated care services will be measured using semi-structured qualitative interviews within the coming 12 months: 1. Design of current integrated respiratory service and operational details of the service 2. How the service was established – who, when, why 3. Training requirements and provision for staff training, including any involvement of trainees 4. Successes/benefits of the service 5. Challenges/barriers to the service Trainee attitudes and experiences of integrated respiratory services will be surveyed within the next 12 months. The following outcomes will be measured: 1. Profession 2. Training region 3. Training level 4. Age 5. Sex 6. Type of training in integrated respiratory services 7. Length of training in integrated respiratory services 8. Confidence in working within integrated respiratory services 9. Plans for involvement in integrated respiratory services after completion of training 10. Opinions on outstanding training requirements Interviews will be transcribed verbatim and combined with the findings from the trainee survey and analysed according to the Framework Method. Further evaluation of the qualitative data will use the Consolidated Frame for Implementation Research which will allow themes identified during the initial Framewo | — |
Secondary
| Measure | Time frame |
|---|---|
| Objective 2: Air quality data will also be linked to the admission periods within the next 12 months | — |
Countries
England, United Kingdom
Contacts
Public ContactLucy Boast
Outcome results
None listed