Spirometry in shared care: COPD prevalence in substance misuse clinics
Research type
Research Study
Full title
Commissioning spirometry at the shared care substance misuse clinic as part of a service development: an opportunity to collect data to inform future research
IRAS ID
181106
Contact name
Hassan Burhan
Contact email
Sponsor organisation
Royal Liverpool & Broadgreen University Hospitals Trust
Duration of Study in the UK
0 years, 6 months, 31 days
Research summary
Heroin addiction is strongly associated with socio-economic depravation and poor physical health. The majority of heroin is smoked rather than injected. Opiate substitute therapy (OST) is the replacement of illicit heroin with methadone (or, less commonly, Buprenorphine). This reduces mortality and harm. In Liverpool, OST is prescribed by GPs and methadone prescriptions, as well as support, are given to clients by drugs key workers employed by Addaction, a third sector organisation. This is termed shared care. \n\nChronic Obstructive Pulmonary Disease (COPD) is caused by smoking and is the most significant single cause of death in people on OST in Liverpool. COPD presents earlier, is more severe and rapidly progressive and causes more premature mortality in heroin smokers than those who have smoked tobacco only. Early diagnosis and intervention in COPD is associated with improved outcomes, decreased morbidity and mortality. Diagnosis of COPD requires a simple breathing test called spirometry.\n\nPatients on OST are recognised as ’hard to reach’. They almost ubiquitously smoke tobacco and are at risk of COPD. The condition is under diagnosed in this group who rarely engage with healthcare unless unwell. Effective interventions in hard to reach groups focus around engaging patients at the point where they most readily access the healthcare system. For patients on OST, this is the place they receive their methadone prescription: the community substance misuse clinic. \n\nA shared care service modification is planned to screen OST patients at their regular substance misuse clinic appointments for COPD using spirometry. The MRC dyspnoea score and oxygen saturations will also be recorded. Individual results will be given to clients and their GPs for appropriate follow up.\n\nThis research is independent of the service modification. Analysis of anonymised data collated as part of the service modification will be undertaken to produce a service evaluation. \n
REC name
North West - Haydock Research Ethics Committee
REC reference
16/NW/0295
Date of REC Opinion
25 Apr 2016
REC opinion
Favourable Opinion