Does ensuring people go home from hospital on the right inhalers after an exacerbation of chronic obstructive pulmonary disease reduce the risk of being re-admitted to hospital?

Optimised inhalers to reduce chronic obstructive pulmonary disease exacerbation re-admissions and mortality: a feasibility study

Status

Active, not recruiting

Phases

Unknown

Study type

Observational

Source

ISRCTN

Registry ID

ISRCTN16732324

Enrollment

300

Registered

2022-09-08

Start date

2022-10-03

Completion date

Unknown

Last updated

2024-07-29

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Exacerbations of chronic obstructive pulmonary disease (COPD) Respiratory Other chronic obstructive pulmonary disease

Interventions

Participants' clinicians will use a new tool to see if they are on the right inhalers. If not, they will suggest making a switch. Participants will then be phoned at 30 and 90 days to see how they got

Eligibility

Sex/Gender

All

Inclusion criteria

Inclusion criteria: 1. In hospital with an exacerbation of COPD 2. Age 18 years or over 3. Able to provide informed consent

Exclusion criteria

Exclusion criteria: Discharge home with palliative care

Design outcomes

Primary

Measure	Time frame
The primary aim of this study is to establish the feasibility of a future definitive trial; as such the feasibility outcomes are to measure: 1. The proportion of patients prescribed incorrect inhaled medicine, according to NICE guidance, assessed by review of the prescription chart and admission documentation prior to discharge 2. The proportion of patients with critical inhaler device errors, assessed by direct observation of technique prior to discharge 3. The proportion of patients with insufficient peak inspiratory flow rate for their current device, assessed using the In-Check device prior to discharge 4. The proportion of patients willing to have inhalers changed where a change is indicated, assessed by asking the patient prior to discharge 5. Of those eligible for an inhaler change, the proportion of patients in which the change is made and if not why not, by assessing the discharge prescription and interview with clinicians at the point of discharge 6. Of those who had an inhaler change, the continuation of that change in the community assessed by patient interview at 30 and 90 days 7. Patient perception of inhaled medication assessed using the Feeling of Satisfaction with Inhaler (FSI-10) questionnaire prior to discharge and at 30- and 90 days 8. Loss to follow-up at 30 and 90 days 9. Challenges in data collection assessed by interviews with clinicians using the tool throughout the study period 10. The time taken to collect the data and deliver the inhaler selection tool, assessed by timing use of the tool at the point of use 11. The first language distribution of patients with COPD at the three sites, to understand the need for translation of trial materials, assessed by interviews with patients prior to discharge	—

Measure

Time frame

The primary aim of this study is to establish the feasibility of a future definitive trial; as such the feasibility outcomes are to measure: 1. The proportion of patients prescribed incorrect inhaled medicine, according to NICE guidance, assessed by review of the prescription chart and admission documentation prior to discharge 2. The proportion of patients with critical inhaler device errors, assessed by direct observation of technique prior to discharge 3. The proportion of patients with insufficient peak inspiratory flow rate for their current device, assessed using the In-Check device prior to discharge 4. The proportion of patients willing to have inhalers changed where a change is indicated, assessed by asking the patient prior to discharge 5. Of those eligible for an inhaler change, the proportion of patients in which the change is made and if not why not, by assessing the discharge prescription and interview with clinicians at the point of discharge 6. Of those who had an inhaler change, the continuation of that change in the community assessed by patient interview at 30 and 90 days 7. Patient perception of inhaled medication assessed using the Feeling of Satisfaction with Inhaler (FSI-10) questionnaire prior to discharge and at 30- and 90 days 8. Loss to follow-up at 30 and 90 days 9. Challenges in data collection assessed by interviews with clinicians using the tool throughout the study period 10. The time taken to collect the data and deliver the inhaler selection tool, assessed by timing use of the tool at the point of use 11. The first language distribution of patients with COPD at the three sites, to understand the need for translation of trial materials, assessed by interviews with patients prior to discharge

—

Secondary

Measure	Time frame
In addition, to inform the power calculation for a definitive study, the researchers will assess: 1. The mortality rate at 30 and 90 days, by review of electronic patient records 2. The all-cause re-admission rate at 30 and 90 days, by patient interview 3. The acceptability of the intervention is assessed using qualitative interviews. Then, based on input from trial participants and clinicians, the researchers will further refine and develop the inhaler selection tool. These interviews will be conducted after discharge.	—

Measure

Time frame

In addition, to inform the power calculation for a definitive study, the researchers will assess: 1. The mortality rate at 30 and 90 days, by review of electronic patient records 2. The all-cause re-admission rate at 30 and 90 days, by patient interview 3. The acceptability of the intervention is assessed using qualitative interviews. Then, based on input from trial participants and clinicians, the researchers will further refine and develop the inhaler selection tool. These interviews will be conducted after discharge.

—

Countries

England, United Kingdom

Contacts

Public ContactAnne-Marie Preston

anne-marie.preston@nhs.net+44 (0)20 7794 0500

Outcome results

None listed

Source: ISRCTN (via WHO ICTRP) · Data processed: Feb 4, 2026