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GPs and hospital staff across Devon collaborate to increase opportunities for COPD patients to take part in research

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More people in Devon have been able to take part in research investigating the best treatment for COPD (chronic obstructive pulmonary disease), thanks to an innovative collaboration between primary and secondary care. 

The NIHR-funded MucAct COPD study is testing whether breathing in sodium chloride (salty water) through a nebuliser can help patients with the disease cough up phlegm, make them feel better and cut down the number of chest infections they get. It is also investigating whether this is better than taking a drug known as carbocisteine (either as tablets or an oral solution), which is also thought to help patients clear phlegm from the chest.

Although MucAct was designed to recruit and be delivered in secondary care, in the South West the NIHR Clinical Research Network South West Peninsula (CRN SWP) and the Royal Devon University Healthcare NHS Foundation Trust have been able to improve the experience for volunteers, and recruit more people, by involving GP practices.

Supported by the NIHR CRN SWP, GP practices in Devon identify which of their patients could potentially be eligible for MucAct (because they have a diagnosis of COPD). Patients who volunteer to take part are offered appointments at local NHS sites such as community hospitals, rather than the Royal Devon and Exeter (RD&E) Hospital (Wonford), reducing travel times for participants.  

Allan Cross, 70, from Exmouth got the chance to participate in MucAct through his GP practice, Claremont Surgery. Mr Cross, a retired Class 1 HGV driver who served in the Army for 22 years, was randomised into the group taking carbocisteine tablets last summer, and has been attending study appointments at his local community hospital. He said not having to travel to the RD&E Hospital (Wonford) made it easier for him to take part in the study.

Mr Cross said: “I’ve had COPD for quite a few years and it’s getting worse. I can’t walk too far, so I tend not to go out very much anymore. But taking part in this study was very easy, all I had to do really was send the diaries in every three weeks and attend a few appointments locally. I am very happy to get involved and see if I can help, and I don’t mind taking part at all.”

Research Practitioner Donna Underwood is part of the NIHR CRN SWP Mid-Devon Agile Research Delivery Team (ARDT). She said: “We have worked closely with numerous GP surgeries in Exeter and the surrounding areas, screening any potentially eligible participants and then contacting them to discuss the study and determine if they are interested in taking part. If so, they are referred to the Respiratory Research Nurses at the Royal Devon for a follow up call and initial study visit.

“This strong collaboration between the Primary Care ARDT and the team at the Royal Devon, with the aim of enhancing the lives of those patients in Devon who have COPD, has been a positive and productive experience, and as a result we have been one of the front runners in national recruitment.”

Royal Devon Research Nurse Anne McGahey said: “MucAct is transformational research because although it was initially supposed to be a secondary care study, we were successfully able to roll it out into primary care.

“Volunteers participate for a year, with three face to face visits, preferably at their local community hospital, or at the RD&E Hospital (Wonford) if this is close to them. At each of the three visits they complete quality of life questionnaires and spirometry.

“The NIHR CRN SWP Agile team was essential to the successful delivery of MucAct, and supported by doing pre-screening through GP practices for us, identifying patients and passing them on to us to try to recruit.

“The study is important as it is testing the effectiveness of the saline against the tablet and it's potential to reduce the number of infections over the course of the year.

“Standard clinical practice is to use both medications to help bring up sputum, but the saline would usually be 0.9% in clinical practice, whereas MucAct is testing a 7% solution. So we hope to find that the saltier solution, as used in other respiratory conditions such as cystic fibrosis and bronchiectasis, is more efficient.”

To find out more about research in your area, visit the NIHR’s Be Part of Research service website: