MISSION ABC: transforming respiratory care through one-stop multidisciplinary clinics – an observational study
Objectives The Modern Innovative Solutions to Improve Outcomes in Asthma, Breathlessness and Chronic Obstructive Pulmonary Disease (COPD) (MABC) service aimed to enhance disease management for chronic respiratory conditions through specialist multidisciplinary clinics, predominantly in the community...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2024-01-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/14/1/e078947.full |
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| author | Anoop J Chauhan Thomas Brown Daniel Neville Selina Begum Richard Jackson Ruth DeVos Emily Heiden MARK SANDERS Hitasha Rupani Jayne Longstaff Milan J A Chauhan Ellie Lanning Thomas Llewelyn Jones Mark Amos Mark Mottershaw Joanne Micklam Ben Holdsworth Jona Baghammar Kathryn Bannell Rachel Dominey Robert Guile Anthony Leung Fiona Maxwell Dave Meehan Sara Moseley Marcus Pullen Kathleen A Rickard Matt Whiteman |
| author_facet | Anoop J Chauhan Thomas Brown Daniel Neville Selina Begum Richard Jackson Ruth DeVos Emily Heiden MARK SANDERS Hitasha Rupani Jayne Longstaff Milan J A Chauhan Ellie Lanning Thomas Llewelyn Jones Mark Amos Mark Mottershaw Joanne Micklam Ben Holdsworth Jona Baghammar Kathryn Bannell Rachel Dominey Robert Guile Anthony Leung Fiona Maxwell Dave Meehan Sara Moseley Marcus Pullen Kathleen A Rickard Matt Whiteman |
| collection | DOAJ |
| description | Objectives The Modern Innovative Solutions to Improve Outcomes in Asthma, Breathlessness and Chronic Obstructive Pulmonary Disease (COPD) (MABC) service aimed to enhance disease management for chronic respiratory conditions through specialist multidisciplinary clinics, predominantly in the community. This study assesses the outcomes of these clinics.Design This study used a prospective, longitudinal, participatory action research approach.Setting The study was conducted in primary care practices across Hampshire, UK.Participants Adults aged 16 years and above with poorly controlled asthma or COPD, as well as those with undifferentiated breathlessness not under specialist care, were included.Interventions Participants received care through the multidisciplinary, specialist-led MABC clinics.Primary and secondary outcome measures Primary outcomes included disease activity, quality of life and healthcare utilisation. Secondary outcomes encompassed clinic attendance, diagnostic changes, patient activation, participant and healthcare professional experiences and cost-effectiveness.Results A total of 441 participants from 11 general practitioner practices were recruited. Ninety-six per cent of participants would recommend MABC clinics. MABC assessments led to diagnosis changes for 64 (17%) participants with asthma and COPD and treatment adjustments for 252 participants (57%). Exacerbations decreased significantly from 236 to 30 after attending the clinics (p<0.005), with a mean reduction of 0.53 exacerbation events per participant. Reductions were also seen in unscheduled and out-of-hours primary care attendance, emergency department visits and hospital admissions (all p<0.005). Cost savings from reduced exacerbations and healthcare utilisation offset increased medication costs and clinic expenses.Conclusions Specialist-supported multidisciplinary teams in MABC clinics improved diagnosis accuracy and adherence to guidelines. High patient satisfaction, disease control improvements and reduced exacerbations resulted in decreased unscheduled healthcare use and cost savings.Trial registration number NCT03096509. |
| format | Article |
| id | doaj-art-6870105e4d4841bf835b18eb190e53fd |
| institution | OA Journals |
| issn | 2044-6055 |
| language | English |
| publishDate | 2024-01-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-6870105e4d4841bf835b18eb190e53fd2025-08-20T02:12:46ZengBMJ Publishing GroupBMJ Open2044-60552024-01-0114110.1136/bmjopen-2023-078947MISSION ABC: transforming respiratory care through one-stop multidisciplinary clinics – an observational study Anoop J Chauhan0Thomas Brown1Daniel Neville2Selina Begum3Richard JacksonRuth DeVos4Emily Heiden5MARK SANDERSHitasha Rupani6Jayne Longstaff7Milan J A Chauhan8Ellie Lanning9Thomas Llewelyn Jones10Mark Amos11Mark Mottershaw12Joanne Micklam13Ben Holdsworth14Jona BaghammarKathryn BannellRachel DomineyRobert GuileAnthony LeungFiona MaxwellDave MeehanSara MoseleyMarcus PullenKathleen A RickardMatt WhitemanResearch and Innovation, Portsmouth Hospitals University NHS Trust, Portsmouth, UKRespiratory Centre, Portsmouth Hospitals University NHS Trust, Portsmouth, UKRespiratory Centre, Portsmouth Hospitals University NHS Trust, Portsmouth, UKResearch and Innovation, Portsmouth Hospitals University NHS Trust, Portsmouth, UKRespiratory Centre, Portsmouth Hospitals University NHS Trust, Portsmouth, UKRespiratory Centre, Portsmouth Hospitals University NHS Trust, Portsmouth, UKRespiratory Centre, Portsmouth Hospitals University NHS Trust, Portsmouth, UKRespiratory Centre, Portsmouth Hospitals University NHS Trust, Portsmouth, UKResearch and Innovation, Portsmouth Hospitals University NHS Trust, Portsmouth, UKRespiratory Centre, Portsmouth Hospitals University NHS Trust, Portsmouth, UKRespiratory Centre, Portsmouth Hospitals University NHS Trust, Portsmouth, UKFaculty of Science, University of Portsmouth, Portsmouth, UKRespiratory Centre, Portsmouth Hospitals University NHS Trust, Portsmouth, UKDietetics, Portsmouth Hospitals University NHS Trust, Portsmouth, UKInsypher, London, UKObjectives The Modern Innovative Solutions to Improve Outcomes in Asthma, Breathlessness and Chronic Obstructive Pulmonary Disease (COPD) (MABC) service aimed to enhance disease management for chronic respiratory conditions through specialist multidisciplinary clinics, predominantly in the community. This study assesses the outcomes of these clinics.Design This study used a prospective, longitudinal, participatory action research approach.Setting The study was conducted in primary care practices across Hampshire, UK.Participants Adults aged 16 years and above with poorly controlled asthma or COPD, as well as those with undifferentiated breathlessness not under specialist care, were included.Interventions Participants received care through the multidisciplinary, specialist-led MABC clinics.Primary and secondary outcome measures Primary outcomes included disease activity, quality of life and healthcare utilisation. Secondary outcomes encompassed clinic attendance, diagnostic changes, patient activation, participant and healthcare professional experiences and cost-effectiveness.Results A total of 441 participants from 11 general practitioner practices were recruited. Ninety-six per cent of participants would recommend MABC clinics. MABC assessments led to diagnosis changes for 64 (17%) participants with asthma and COPD and treatment adjustments for 252 participants (57%). Exacerbations decreased significantly from 236 to 30 after attending the clinics (p<0.005), with a mean reduction of 0.53 exacerbation events per participant. Reductions were also seen in unscheduled and out-of-hours primary care attendance, emergency department visits and hospital admissions (all p<0.005). Cost savings from reduced exacerbations and healthcare utilisation offset increased medication costs and clinic expenses.Conclusions Specialist-supported multidisciplinary teams in MABC clinics improved diagnosis accuracy and adherence to guidelines. High patient satisfaction, disease control improvements and reduced exacerbations resulted in decreased unscheduled healthcare use and cost savings.Trial registration number NCT03096509.https://bmjopen.bmj.com/content/14/1/e078947.full |
| spellingShingle | Anoop J Chauhan Thomas Brown Daniel Neville Selina Begum Richard Jackson Ruth DeVos Emily Heiden MARK SANDERS Hitasha Rupani Jayne Longstaff Milan J A Chauhan Ellie Lanning Thomas Llewelyn Jones Mark Amos Mark Mottershaw Joanne Micklam Ben Holdsworth Jona Baghammar Kathryn Bannell Rachel Dominey Robert Guile Anthony Leung Fiona Maxwell Dave Meehan Sara Moseley Marcus Pullen Kathleen A Rickard Matt Whiteman MISSION ABC: transforming respiratory care through one-stop multidisciplinary clinics – an observational study BMJ Open |
| title | MISSION ABC: transforming respiratory care through one-stop multidisciplinary clinics – an observational study |
| title_full | MISSION ABC: transforming respiratory care through one-stop multidisciplinary clinics – an observational study |
| title_fullStr | MISSION ABC: transforming respiratory care through one-stop multidisciplinary clinics – an observational study |
| title_full_unstemmed | MISSION ABC: transforming respiratory care through one-stop multidisciplinary clinics – an observational study |
| title_short | MISSION ABC: transforming respiratory care through one-stop multidisciplinary clinics – an observational study |
| title_sort | mission abc transforming respiratory care through one stop multidisciplinary clinics an observational study |
| url | https://bmjopen.bmj.com/content/14/1/e078947.full |
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