Equality in Access to Care
Outcomes achieved using a digital service model for COPD
Deprivation demographics of service users mirrored local disease burden with the majority of users representing the most deprived 20% of the population.
A high level of regular service interaction was observed with 80% of Scottish IMD Quintile 1 users self-reporting at least once per week over the first year.
Let's look at what that means when considering how Lenus can transform the traditional COPD pathway.
How the Lenus Service has demonstrated equality in access to care
RECEIVER participants in Scottish IMD Quintile 1
Local disease burden in Scottish IMD Quintile 1
Scottish IMD Quintile 1 participants with weekly service interactions over first year
Scottish IMD Quintile 2-5 participants with weekly service interactions over first year
More information on the data visualised
|n||NHS GGC COPD population||83 (at baseline)|
|Inclusion Criteria||Patients aged 40 years and over with 1-3 emergency admissions for COPD within the 2018/19 financial year. Patients were resident within NHS GGC||RECEIVER cohort criteria|
|Quintile Criteria||Scottish IMD ranking criteria|
|RECEIVER Scottish IMD Q1||RECEIVER Scottish IMD Q2-Q5|
|n||48 (at baseline)||35 (at baseline)|
|Inclusion Criteria||RECEIVER cohort criteria + resident in Scottish IMD quintile 1 postcode areas||RECEIVER cohort criteria + resident in Scottish IMD quintile 2-5 postcode areas|
Number of weekly interactions was determined by the number of daily CAT entries completed each week. Service interaction levels were calculated relative to the number of service users who were alive and onboarded long enough to complete entries at each timepoint.
- NHS GGC: NHS Greater Glasgow and Clyde, SIMD: Scottish Index of Multiple Deprivation – a relative measure of deprivation across areas in Scotland based on seven domains: education, health, access to services, income, employment, housing, and crime. Q1: quintile 1 (most deprived postcode areas), Q5: quintile 5 (most affluent postcode areas).
- NHS GGC COPD Data Source: Data obtained from PHS (Public Health Scotland) - Data & Intelligence. Data: rate of patients aged 40 years and over with 1-3 emergency admissions for COPD within the 2018/19 financial year. Patients were resident within NHS GGC.
ClinicalTrials.gov Identifier: NCT04240353
The feasibility and service adoption observational cohort RECEIVER trial was commenced in September 2019 by NHS Greater Glasgow and Clyde to evaluate 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 protocol is published here with the full results available here.
Selected from the NHS Greater Glasgow and Clyde Safe Haven COPD dataset. Control cohort identification was conducted by iteratively identifying the individuals in the cohort who met the matching criteria for each RECEIVER participant. Duplicate control patients or individuals subsequently onboarded to Lenus COPD were excluded and then the optimal 5 matches for each RECEIVER participant were determined based on closest matches by age. The matching criteria were that matched individuals must: be alive at the onboarding date of the RECEIVER participant, be the same sex as the RECEIVER participant, and have had a COPD or respiratory related admission in the 7 days prior to the RECEIVER participant's onboarding date.
|At least one severe COPD exacerbation in the year prior to onboarding to Lenus COPD and/or chronic hypercapnic respiratory failure/sleep disordered breathing requiring NIV/CPAP treatment.|
|1st Participant Index Date||3rd September 2019|
|Censor Date||31st August 2021|
Medtech Innovation Briefing
The National Institute of Health and Care Excellence (NICE) has developed a medtech innovation briefing (MIB) on Lenus COPD Support Service for remotely managing chronic obstructive pulmonary disease available here.
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