Outcomes achieved using a digital service model for COPD
Improved probability of admission-free survival was observed through a flattening of the Kaplan-Meier curve in the RECEIVER group with these participants matched to a control reference population.
12-month admission or death rates and median time to admission or death were also greatly improved for Lenus service users in the RECEIVER cohort compared to the control.
Let's look at what that means when considering how Lenus can transform the traditional COPD pathway.
How the Lenus Service has improved survival for users.
12-month mortality rate in control
12-month mortality rate in RECEIVER
Days to admission/death in control
Days to admission/death in RECEIVER
More information on the data visualised
|Inclusion Criteria||Control cohort criteria||RECEIVER cohort criteria||Dynamic-Scot 1 cohort criteria|
The time to a patient's first hospital admission was taken as the 'time to event'.
If death occurred before a hospital admission, this was taken instead.
In the case that a patient was not admitted or deceased, 'time to event' was censored at the data censor date (31/08/2021).
'Time to event' was censored at 600 days.
Dynamic-Scot 1 data did not go beyond 482 days relative to onboarding, hence the early censoring of data.
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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