Leicester City Primary Care worked with Clinitouch to reduce their very high non-elective chronic obstructive pulmonary disease (COPD) re-admission rate. They sought to achieve this goal by improving the management of COPD patients by using remote patient monitoring and increasing patient understanding of their COPD.

20% of patients with COPD are responsible for almost half of COPD admissions⁽¹⁾. COPD patients with frequent exacerbations continue to have frequent exacerbations^(2,3,4). Leicester City Primary Care recognised that they were more likely to reduce admissions by targeting people with two or more prior admissions in the previous 12 months.

Aims & Objectives

• To reduce unscheduled hospital admissions for COPD patients
• To reduce increasing costs related to high admission rates for acute exacerbations of COPD
• To improve patient empowerment through effective self-management of COPD

How it works

• Leicester City Primary Care - chose Clinitouch as their remote patient monitoring platform to enhance the care of patients with COPD.
• Clinitouch - uses a traffic light system (red, amber, green) based upon daily health status questions and clinical observations filled out by patients. This helps clinicians to detect early symptoms of deterioration and intervene as soon as possible.
• Respiratory specialist nurses and physiotherapists - promoted earlier use of exacerbation packs (oral steroids and antibiotics), signposted patients to other services and helped enable a better understanding of patients’ COPD. They also delivered more complex interventions at home when required.

Evaluation

The outcomes of Clinitouch usage were evaluated by analysing admissions data from University Hospitals of Leicester. Comparing the impact on admissions and resource use to the previous 12 months, with patients acting as their own controls. 74 patients with COPD used Clinitouch over 12 months for this research.

Results

• Two-thirds reduction in unscheduled hospital admissions when using Clinitouch (compared to previous 12 months)
• £117,550 net saving to the healthcare system
• Patients were more knowledgable and confident in managing their COPD

Benefits

The programme effectively reduced COPD-related hospital admissions and costs, despite involving a small number of patients the savings were significant. Clinitouch remains in use across NHS Leicester, Leicestershire and Rutland some 10 years later and the platform has evolved substantially over the years.

To read more about this programme, evaluation and beneficial outcomes refer to - Combined interventions for COPD admissions within an urban setting(5).

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^{(1) Data on File. Spirit Health. SSB. anonymised COPD admissions data England 2019-20. 2022.
(2) Hurst JR, Vestbo J, Anzueto A, et al (2010) Susceptibility to exacerbation in chronic obstructive pulmonary disease.
(3) N Engl J 363(12): 1128–1138 Quint JK, Donaldson GC, Hurst JR, Goldring JJ, Seemungal TR, Wedzicha JA (2011) Predictive accuracy of patient-reported exacerbation frequency in COPD. Eur Respir J 37(3): 501–507.
(4) Vestbo J, Hurd SS, Agusti AG et al (2013) Global Strategy for the Diagnosis, Management and Prevention of Chronic Obstructive Pulmonary Disease, GOLD Executive Summary. Am J Respir Crit Care Med 187(4): 347–365.
(5) Ghosh S, et al. Combined interventions for COPD admissions within an urban setting. Br J HCM 2016: 22 (3);225 - 22.}