Workload Manageability
Outcomes achieved using a digital service model for COPD
Clinician workload was reported as manageable with asynchronous messaging and remote service onboarding achieving beneficial channel shifts.
Let's look at what that means when considering how Lenus can transform the traditional COPD pathway.
Evidence stats
How the Lenus Service has demonstrated a channel shift in workload
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4 hr
Average clinical use per day to manage around 500 patients
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15-20
Daily patient-clinician messages exchanged via service
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142
Service users recruited and onboarded remotely
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308
Patients self-referred to service during scale-up
Chart supplement
More information on the data visualised
| Service Users (resident in Scottish IMD quintile 1 postcode areas) | |
|---|---|
| N | Variable depending on number onboarded, alive and participating in the study at each time point. |
| Inclusion Criteria | RECEIVER and Dynamic-Scot 1 participants. |
| Messaging Criteria |
Number of LenusCOPD patients was determined on a weekly basis, taking into account service onboardings, patient drop-outs, and patient deaths. Messaging counts include both patient- and clinican-sent messages. |
| Data Censoring |
The final week of data before censoring was the 13/08/2021- 19/08/2021. |
- Number of Lenus COPD patients follows y-axis scale of messages sent
- Scale-Up resulted in an increase in patient messaging. After all service users are onboarded, patient messaging activity decreases, which likely partly reflects improved self-management awareness. Further increases in patient service users can therefore be accommodated across scale-up, with a stable messaging workload.
- Apparent drop in patient numbers is due to messaging data being censored at 142 patients who achieved 1-year follow-up with some patients dropping out or becoming deceased. Service scale-up did continue and patient numbers did increase.
Study details
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 | |
|---|---|---|---|---|
| Inclusion Criteria |
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 | |||
| Total Patients | 405 | 83 | 142 | 225 |
| Service Users (resident in Scottish IMD quintile 1 postcode areas) | |
|---|---|
| N | Variable depending on number onboarded, alive and participating in the study at each time point. |
| Inclusion Criteria | RECEIVER and Dynamic-Scot 1 participants. |
| Messaging Criteria |
Number of LenusCOPD patients was determined on a weekly basis, taking into account service onboardings, patient drop-outs, and patient deaths. Messaging counts include both patient- and clinican-sent messages. |
| Data Censoring |
The final week of data before censoring was the 13/08/2021- 19/08/2021. |
NICE advice
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.
Get in touch
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