Equality in Access to Care
Outcomes achieved using a digital service model for COPD
Deprivation demographics of service users mirrored local disease burden with high uptake and consistent results achieved across socio-economic groups.
Sustained usage was observed in service users resident in the most deprived 20% of the population tracking closely to PRO completion habits for all service users.
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
Local disease burden in Scottish IMD Quintile 1
Service users in Scottish IMD Quintile 1
Service users completed at least one PRO set per week at 1 year follow-up
SIMD Quintile 1 users completed at least one PRO set per week at 1 year follow-up
More information on the data visualised
|NHS GG&C COPD Cohort||Service users|
|N||NHS GG&C COPD population.||225 (at baseline)|
Aged 40 years and over.
1-3 emergency admissions for COPD within the 2018/19 financial year.
Resident within the NHS GG&C health board.
|RECEIVER and Dynamic-Scot 1 participants.|
|Quintile Criteria||Scottish IMD ranking criteria|
|Service users (all)||Service Users (resident in Scottish IMD quintile 1 postcode areas)|
|N||225 (at baseline)||109 (at baseline)|
|Inclusion Criteria||RECEIVER and Dynamic-Scot 1 participants.||RECEIVER and Dynamic-Scot 1 participants resident in Scottish IMD quintile 1 postcode areas.|
Number of weekly interactions was determined by the number of daily CAT entries completed each week.
Percentage of service users with at least one entry per week was calculated from the service users who were alive and onboarded long enough to complete entries at each weekly timepoint.
Data for each service user was censored at whichever time period was shortest:
- NHS GG&C: NHS Greater Glasgow & 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 GG&C 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 GG&C.
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. In March 2021, 'RECEIVER' recruitment was paused and a 'Dynamic-Scot' cohort was established through remote recruitment in the Covid-19 service scale-up to routine care. The protocol is published here with the full results available here.
|Control||RECEIVER||Dynamic-Scot 1||Service users|
Selected from the NHS Greater Glasgow and Clyde SafeHaven dataset.
Diagnosis of COPD + a COPD-related hospital admission within a 14-day window of a reference RECEIVER trial participant's onboarding date were criteria for entry.
From these criteria, the optimal ~5 matches for each RECEIVER participant were determined based on sex and age whilst excluding duplicate control patients or individuals subsequently onboarded to Lenus COPD.
|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.||Onboarded at least 365 days before 31/08/2021 (the data censor date for analyses).||RECEIVER and Dynamic-Scot 1 participants.|
|1st Participant Index Date||3rd September 2019||3rd September 2019||15th May 2020||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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