RECEIVER clinical trial

Chronic Obstructive Pulmonary Disease (COPD) is a significant health concern in the UK, causing nearly 30,000 deaths and over a million hospital bed days annually. Scotland and northern England have the highest prevalence and mortality rates, with COPD being more common in socioeconomically deprived areas. Current COPD management is often reactive, primarily during hospitalizations, potentially worsening the patient's condition. Self-management has shown to reduce hospital admissions but can be resource-intensive. Digital tools like the Lenus COPD service offer scalable solutions. Launched by NHS Greater Glasgow and Clyde (NHS GG&C), the Lenus COPD support service includes a patient web application, self-management resources, and a clinician dashboard. Initially part of the RECEIVER trial for severe COPD patients, it became routine care during the COVID-19 pandemic.

Study Objectives

A prospective observational cohort hybrid implementation-effectiveness study commenced in September 2019 and was run by NHS Greater Glasgow and Clyde. It evaluated the implementation and efficacy of the Lenus COPD Service with high-risk COPD participants matched 1:5 to a control cohort using de-identified contemporary routine clinical data. The study monitored 83 patients using the digital service between September 2019 - August 2021. 

Study details ClinicalTrials.gov Identifier: NCT04240353 

Results

The study evidenced sustained usage of the Lenus COPD Support Service by high-risk patients with COPD, significantly reducing hospital admissions and occupied bed-days.  Patients stayed well for longer at home, doubling the time to admission or death in the study cohort, and reducing the mortality rate by 30% compared to the control group.  The study also highlighted equitable access to the digital service from deprived communities. 

Key Findings

• Sustained usage was maintained with patient engaged with the service average 4 times per week during the study, with 77% sustaining use at 78 week follow up.  

• There was a 49% greater related reduction in admissions in the study cohort compared to the control cohort following the intervention with an average of 4.74 less occupied bed days versus the control cohort. 

• Time to admission or death was extended from 155 days in the control cohort to 335 days in the intervention arm. 

• 12-month mortality rate was 24% in the control to 17% in the study cohort.  

• Quality of life and symptom burden remained stable in the RECEIVER cohort despite the progressive nature of COPD.  

• The study also evidenced equity of access to digital service from deprived communities, with 58% RECEIVER participants in Scottish IMD Quintile 1. 

Reference

International Journal of COPD June 2023