Protocol for the enhanced management of multimorbid patients with COPD and severe asthma: role of indoor air quality
Introduction Reducing unplanned hospital admissions in chronic patients at risk is a key area for action due to the high healthcare and societal burden of the phenomenon. The inconclusive results of preventive strategies in patients with chronic obstructive respiratory disorders and comorbidities ar...
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| Language: | English |
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BMJ Publishing Group
2025-01-01
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| Series: | BMJ Open Respiratory Research |
| Online Access: | https://bmjopenrespres.bmj.com/content/12/1/e002589.full |
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| author | Emili Vela Isaac Cano Josep Roca Antoni Sisó-Almirall Carme Hernandez Ebymar Arismendi Ramon Farré Alba Gómez-López María Figols Antonio Montilla-Ibarra Núria Sánchez-Ruano Benigno Sánchez Marta Sorribes Jordi Piera-Jiménez Jaume Benavent Jose Fermoso Rubèn González-Colom |
| author_facet | Emili Vela Isaac Cano Josep Roca Antoni Sisó-Almirall Carme Hernandez Ebymar Arismendi Ramon Farré Alba Gómez-López María Figols Antonio Montilla-Ibarra Núria Sánchez-Ruano Benigno Sánchez Marta Sorribes Jordi Piera-Jiménez Jaume Benavent Jose Fermoso Rubèn González-Colom |
| author_sort | Emili Vela |
| collection | DOAJ |
| description | Introduction Reducing unplanned hospital admissions in chronic patients at risk is a key area for action due to the high healthcare and societal burden of the phenomenon. The inconclusive results of preventive strategies in patients with chronic obstructive respiratory disorders and comorbidities are explainable by multifactorial but actionable factors.The current protocol (January 2024–December 2025) relies on the hypothesis that intertwined actions in four dimensions: (1) management change, (2) personalisation of the interventions based on early detection/treatment of acute episodes and enhanced management of comorbidities, (3) mature digital support and (4) comprehensive assessment, can effectively overcome most of the limitations shown by previous preventive strategies. Accordingly, the main objective is to implement a novel integrated care preventive service for enhanced management of these patients, as well as to evaluate its potential for value generation.Methods and analysis At the end of 2024, the specifics of the novel service will be defined through the articulation of its four main components: (1) enhanced lung function testing through oscillometry, (2) continuous monitoring of indoor air quality as a potential triggering factor, (3) digital support with an adaptive case management (ACM) approach and (4) predictive modelling for early identification and management of exacerbations. During 2025, the novel service will be assessed using a Quintuple Aim approach. Moreover, the Consolidated Framework for Implementation Research will be applied to assess the implementation. The service components will be articulated through four sequential 6-month plan-do-study-act cycles. Each cycle involves a targeted cocreation process following a mixed-methods approach with the active participation of patients, health professionals, managers and digital experts.Ethics and dissemination The Ethics Committee for Human Research at Hospital Clinic de Barcelona approved the protocol on 29 June 2023 (HCB/2023/0126). Before any procedure, all patients in the study must sign an informed consent form.Trial registration number NCT06421402. |
| format | Article |
| id | doaj-art-1f9f476c43ab4b75808f2577a6ac23b2 |
| institution | Kabale University |
| issn | 2052-4439 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open Respiratory Research |
| spelling | doaj-art-1f9f476c43ab4b75808f2577a6ac23b22025-01-22T05:25:10ZengBMJ Publishing GroupBMJ Open Respiratory Research2052-44392025-01-0112110.1136/bmjresp-2024-002589Protocol for the enhanced management of multimorbid patients with COPD and severe asthma: role of indoor air qualityEmili Vela0Isaac Cano1Josep Roca2Antoni Sisó-Almirall3Carme Hernandez4Ebymar Arismendi5Ramon Farré6Alba Gómez-López7María Figols8Antonio Montilla-Ibarra9Núria Sánchez-Ruano10Benigno Sánchez11Marta Sorribes12Jordi Piera-Jiménez13Jaume Benavent14Jose Fermoso15Rubèn González-Colom16Digitalization for the Sustainability of the Healthcare (DS3) - IDIBELL, Barcelona, SpainFundació de Recerca Clínic Barcelona - Institut d`Investigacions Biomèdiques August Pi i Sunyer (FRCB-IDIBAPS), Barcelona, SpainFundació de Recerca Clínic Barcelona - Institut d`Investigacions Biomèdiques August Pi i Sunyer (FRCB-IDIBAPS), Barcelona, SpainFundació de Recerca Clínic Barcelona - Institut d`Investigacions Biomèdiques August Pi i Sunyer (FRCB-IDIBAPS), Barcelona, SpainFundació de Recerca Clínic Barcelona - Institut d`Investigacions Biomèdiques August Pi i Sunyer (FRCB-IDIBAPS), Barcelona, SpainPulmonology Department, Hospital Clinic de Barcelona, Barcelona, SpainCentro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, SpainFundació de Recerca Clínic Barcelona - Institut d`Investigacions Biomèdiques August Pi i Sunyer (FRCB-IDIBAPS), Barcelona, SpaininBiot, Pamplona, SpainCAP Numancia, Institut Catala de la Salut (ICS), Barcelona, SpainCentres Atencio Primaria de Barcelona-Esquerra (CAPSBE), Barcelona, SpainCentro de Investigaciones Energeticas Medioambientales y Tecnologicas (CIEMAT), Madrid, SpainCAP Numancia, Institut Catala de la Salut (ICS), Barcelona, SpainCatalan Health Service, Barcelona, SpainFundació de Recerca Clínic Barcelona - Institut d`Investigacions Biomèdiques August Pi i Sunyer (FRCB-IDIBAPS), Barcelona, SpainCARTIF Technology Center, Valladolid, SpainFundació de Recerca Clínic Barcelona - Institut d`Investigacions Biomèdiques August Pi i Sunyer (FRCB-IDIBAPS), Barcelona, SpainIntroduction Reducing unplanned hospital admissions in chronic patients at risk is a key area for action due to the high healthcare and societal burden of the phenomenon. The inconclusive results of preventive strategies in patients with chronic obstructive respiratory disorders and comorbidities are explainable by multifactorial but actionable factors.The current protocol (January 2024–December 2025) relies on the hypothesis that intertwined actions in four dimensions: (1) management change, (2) personalisation of the interventions based on early detection/treatment of acute episodes and enhanced management of comorbidities, (3) mature digital support and (4) comprehensive assessment, can effectively overcome most of the limitations shown by previous preventive strategies. Accordingly, the main objective is to implement a novel integrated care preventive service for enhanced management of these patients, as well as to evaluate its potential for value generation.Methods and analysis At the end of 2024, the specifics of the novel service will be defined through the articulation of its four main components: (1) enhanced lung function testing through oscillometry, (2) continuous monitoring of indoor air quality as a potential triggering factor, (3) digital support with an adaptive case management (ACM) approach and (4) predictive modelling for early identification and management of exacerbations. During 2025, the novel service will be assessed using a Quintuple Aim approach. Moreover, the Consolidated Framework for Implementation Research will be applied to assess the implementation. The service components will be articulated through four sequential 6-month plan-do-study-act cycles. Each cycle involves a targeted cocreation process following a mixed-methods approach with the active participation of patients, health professionals, managers and digital experts.Ethics and dissemination The Ethics Committee for Human Research at Hospital Clinic de Barcelona approved the protocol on 29 June 2023 (HCB/2023/0126). Before any procedure, all patients in the study must sign an informed consent form.Trial registration number NCT06421402.https://bmjopenrespres.bmj.com/content/12/1/e002589.full |
| spellingShingle | Emili Vela Isaac Cano Josep Roca Antoni Sisó-Almirall Carme Hernandez Ebymar Arismendi Ramon Farré Alba Gómez-López María Figols Antonio Montilla-Ibarra Núria Sánchez-Ruano Benigno Sánchez Marta Sorribes Jordi Piera-Jiménez Jaume Benavent Jose Fermoso Rubèn González-Colom Protocol for the enhanced management of multimorbid patients with COPD and severe asthma: role of indoor air quality BMJ Open Respiratory Research |
| title | Protocol for the enhanced management of multimorbid patients with COPD and severe asthma: role of indoor air quality |
| title_full | Protocol for the enhanced management of multimorbid patients with COPD and severe asthma: role of indoor air quality |
| title_fullStr | Protocol for the enhanced management of multimorbid patients with COPD and severe asthma: role of indoor air quality |
| title_full_unstemmed | Protocol for the enhanced management of multimorbid patients with COPD and severe asthma: role of indoor air quality |
| title_short | Protocol for the enhanced management of multimorbid patients with COPD and severe asthma: role of indoor air quality |
| title_sort | protocol for the enhanced management of multimorbid patients with copd and severe asthma role of indoor air quality |
| url | https://bmjopenrespres.bmj.com/content/12/1/e002589.full |
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