Interdisciplinary model of care (RADICALS) for early detection and management of chronic obstructive pulmonary disease (COPD) in Australian primary care: Study protocol for a cluster randomised controlled trial

Jenifer Liang, Michael J. Abramson, Nicholas Zwar, Grant Russell, Anne E. Holland, Billie Bonevski, Ajay Mahal, Benjamin Van Hecke, Kirsten Phillips, Paula Eustace, Eldho Paul, Kate Petrie, Sally Wilson, Johnson George

Research output: Contribution to journalArticleResearchpeer-review

3 Citations (Scopus)

Abstract

Introduction Up to half of all smokers develop clinically significant chronic obstructive pulmonary disease (COPD). Gaps exist in the implementation and uptake of evidence-based guidelines for managing COPD in primary care. We describe the methodology of a cluster randomised controlled trial (cRCT) evaluating the efficacy and cost-effectiveness of an interdisciplinary model of care aimed at reducing the burden of smoking and COPD in Australian primary care settings. Methods and analysis A cRCT is being undertaken to evaluate an interdisciplinary model of care (RADICALS-Review of Airway Dysfunction and Interdisciplinary Community-based care of Adult Long-term Smokers). General practice clinics across Melbourne, Australia, are identified and randomised to the intervention group (RADICALS) or usual care. Patients who are current or ex-smokers, of at least 10 pack years, including those with an existing diagnosis of COPD, are being recruited to identify 280 participants with a spirometry-confirmed diagnosis of COPD. Handheld lung function devices are being used to facilitate case-finding. RADICALS includes individualised smoking cessation support, home-based pulmonary rehabilitation and home medicines review. Patients at control group sites receive usual care and Quitline referral, as appropriate. Follow-ups occur at 6 and 12 months from baseline to assess changes in quality of life, abstinence rates, health resource utilisation, symptom severity and lung function. The primary outcome is change in St George's Respiratory Questionnaire score of patients with COPD at 6 months from baseline. Ethics and dissemination This project has been approved by the Monash University Human Research Ethics Committee and La Trobe University Human Ethics Committee (CF14/1018-2014000433). Results of the study will be disseminated in peer-reviewed journals and research conferences. If the intervention is successful, the RADICALS programme could potentially be integrated into general practices across Australia and sustained over time. Trial registration number ACTRN12614001155684; Pre-results.

Original languageEnglish
Article numbere016985
JournalBMJ Open
Volume7
Issue number9
DOIs
Publication statusPublished - 1 Sep 2017
Externally publishedYes

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Chronic Obstructive Pulmonary Disease
Primary Health Care
Randomized Controlled Trials
General Practice
Lung
Ethics Committees
Health Resources
Research Ethics Committees
Spirometry
Long-Term Care
Smoking Cessation
Ethics
Cost-Benefit Analysis
Cluster Analysis
Referral and Consultation
Rehabilitation
Smoking
Quality of Life
Guidelines
Equipment and Supplies

Cite this

Liang, Jenifer ; Abramson, Michael J. ; Zwar, Nicholas ; Russell, Grant ; Holland, Anne E. ; Bonevski, Billie ; Mahal, Ajay ; Van Hecke, Benjamin ; Phillips, Kirsten ; Eustace, Paula ; Paul, Eldho ; Petrie, Kate ; Wilson, Sally ; George, Johnson. / Interdisciplinary model of care (RADICALS) for early detection and management of chronic obstructive pulmonary disease (COPD) in Australian primary care : Study protocol for a cluster randomised controlled trial. In: BMJ Open. 2017 ; Vol. 7, No. 9.
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title = "Interdisciplinary model of care (RADICALS) for early detection and management of chronic obstructive pulmonary disease (COPD) in Australian primary care: Study protocol for a cluster randomised controlled trial",
abstract = "Introduction Up to half of all smokers develop clinically significant chronic obstructive pulmonary disease (COPD). Gaps exist in the implementation and uptake of evidence-based guidelines for managing COPD in primary care. We describe the methodology of a cluster randomised controlled trial (cRCT) evaluating the efficacy and cost-effectiveness of an interdisciplinary model of care aimed at reducing the burden of smoking and COPD in Australian primary care settings. Methods and analysis A cRCT is being undertaken to evaluate an interdisciplinary model of care (RADICALS-Review of Airway Dysfunction and Interdisciplinary Community-based care of Adult Long-term Smokers). General practice clinics across Melbourne, Australia, are identified and randomised to the intervention group (RADICALS) or usual care. Patients who are current or ex-smokers, of at least 10 pack years, including those with an existing diagnosis of COPD, are being recruited to identify 280 participants with a spirometry-confirmed diagnosis of COPD. Handheld lung function devices are being used to facilitate case-finding. RADICALS includes individualised smoking cessation support, home-based pulmonary rehabilitation and home medicines review. Patients at control group sites receive usual care and Quitline referral, as appropriate. Follow-ups occur at 6 and 12 months from baseline to assess changes in quality of life, abstinence rates, health resource utilisation, symptom severity and lung function. The primary outcome is change in St George's Respiratory Questionnaire score of patients with COPD at 6 months from baseline. Ethics and dissemination This project has been approved by the Monash University Human Research Ethics Committee and La Trobe University Human Ethics Committee (CF14/1018-2014000433). Results of the study will be disseminated in peer-reviewed journals and research conferences. If the intervention is successful, the RADICALS programme could potentially be integrated into general practices across Australia and sustained over time. Trial registration number ACTRN12614001155684; Pre-results.",
author = "Jenifer Liang and Abramson, {Michael J.} and Nicholas Zwar and Grant Russell and Holland, {Anne E.} and Billie Bonevski and Ajay Mahal and {Van Hecke}, Benjamin and Kirsten Phillips and Paula Eustace and Eldho Paul and Kate Petrie and Sally Wilson and Johnson George",
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Liang, J, Abramson, MJ, Zwar, N, Russell, G, Holland, AE, Bonevski, B, Mahal, A, Van Hecke, B, Phillips, K, Eustace, P, Paul, E, Petrie, K, Wilson, S & George, J 2017, 'Interdisciplinary model of care (RADICALS) for early detection and management of chronic obstructive pulmonary disease (COPD) in Australian primary care: Study protocol for a cluster randomised controlled trial' BMJ Open, vol. 7, no. 9, e016985. https://doi.org/10.1136/bmjopen-2017-016985

Interdisciplinary model of care (RADICALS) for early detection and management of chronic obstructive pulmonary disease (COPD) in Australian primary care : Study protocol for a cluster randomised controlled trial. / Liang, Jenifer; Abramson, Michael J.; Zwar, Nicholas; Russell, Grant; Holland, Anne E.; Bonevski, Billie; Mahal, Ajay; Van Hecke, Benjamin; Phillips, Kirsten; Eustace, Paula; Paul, Eldho; Petrie, Kate; Wilson, Sally; George, Johnson.

In: BMJ Open, Vol. 7, No. 9, e016985, 01.09.2017.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Interdisciplinary model of care (RADICALS) for early detection and management of chronic obstructive pulmonary disease (COPD) in Australian primary care

T2 - Study protocol for a cluster randomised controlled trial

AU - Liang, Jenifer

AU - Abramson, Michael J.

AU - Zwar, Nicholas

AU - Russell, Grant

AU - Holland, Anne E.

AU - Bonevski, Billie

AU - Mahal, Ajay

AU - Van Hecke, Benjamin

AU - Phillips, Kirsten

AU - Eustace, Paula

AU - Paul, Eldho

AU - Petrie, Kate

AU - Wilson, Sally

AU - George, Johnson

PY - 2017/9/1

Y1 - 2017/9/1

N2 - Introduction Up to half of all smokers develop clinically significant chronic obstructive pulmonary disease (COPD). Gaps exist in the implementation and uptake of evidence-based guidelines for managing COPD in primary care. We describe the methodology of a cluster randomised controlled trial (cRCT) evaluating the efficacy and cost-effectiveness of an interdisciplinary model of care aimed at reducing the burden of smoking and COPD in Australian primary care settings. Methods and analysis A cRCT is being undertaken to evaluate an interdisciplinary model of care (RADICALS-Review of Airway Dysfunction and Interdisciplinary Community-based care of Adult Long-term Smokers). General practice clinics across Melbourne, Australia, are identified and randomised to the intervention group (RADICALS) or usual care. Patients who are current or ex-smokers, of at least 10 pack years, including those with an existing diagnosis of COPD, are being recruited to identify 280 participants with a spirometry-confirmed diagnosis of COPD. Handheld lung function devices are being used to facilitate case-finding. RADICALS includes individualised smoking cessation support, home-based pulmonary rehabilitation and home medicines review. Patients at control group sites receive usual care and Quitline referral, as appropriate. Follow-ups occur at 6 and 12 months from baseline to assess changes in quality of life, abstinence rates, health resource utilisation, symptom severity and lung function. The primary outcome is change in St George's Respiratory Questionnaire score of patients with COPD at 6 months from baseline. Ethics and dissemination This project has been approved by the Monash University Human Research Ethics Committee and La Trobe University Human Ethics Committee (CF14/1018-2014000433). Results of the study will be disseminated in peer-reviewed journals and research conferences. If the intervention is successful, the RADICALS programme could potentially be integrated into general practices across Australia and sustained over time. Trial registration number ACTRN12614001155684; Pre-results.

AB - Introduction Up to half of all smokers develop clinically significant chronic obstructive pulmonary disease (COPD). Gaps exist in the implementation and uptake of evidence-based guidelines for managing COPD in primary care. We describe the methodology of a cluster randomised controlled trial (cRCT) evaluating the efficacy and cost-effectiveness of an interdisciplinary model of care aimed at reducing the burden of smoking and COPD in Australian primary care settings. Methods and analysis A cRCT is being undertaken to evaluate an interdisciplinary model of care (RADICALS-Review of Airway Dysfunction and Interdisciplinary Community-based care of Adult Long-term Smokers). General practice clinics across Melbourne, Australia, are identified and randomised to the intervention group (RADICALS) or usual care. Patients who are current or ex-smokers, of at least 10 pack years, including those with an existing diagnosis of COPD, are being recruited to identify 280 participants with a spirometry-confirmed diagnosis of COPD. Handheld lung function devices are being used to facilitate case-finding. RADICALS includes individualised smoking cessation support, home-based pulmonary rehabilitation and home medicines review. Patients at control group sites receive usual care and Quitline referral, as appropriate. Follow-ups occur at 6 and 12 months from baseline to assess changes in quality of life, abstinence rates, health resource utilisation, symptom severity and lung function. The primary outcome is change in St George's Respiratory Questionnaire score of patients with COPD at 6 months from baseline. Ethics and dissemination This project has been approved by the Monash University Human Research Ethics Committee and La Trobe University Human Ethics Committee (CF14/1018-2014000433). Results of the study will be disseminated in peer-reviewed journals and research conferences. If the intervention is successful, the RADICALS programme could potentially be integrated into general practices across Australia and sustained over time. Trial registration number ACTRN12614001155684; Pre-results.

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U2 - 10.1136/bmjopen-2017-016985

DO - 10.1136/bmjopen-2017-016985

M3 - Article

VL - 7

JO - BMJ Open

JF - BMJ Open

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