A pilot study to characterise patients attending a community setting (LHC) as a potential pathway to identify patients for COPD trials

Chronic obstructive pulmonary disease (COPD) is the 5th biggest killer in the UK. It is characterised by chronic inflammation and punctuated by acute episodes of deterioration. These exacerbations are major contributors to increased morbidity and mortality in COPD. Despite its impact, COPD is often diagnosed late. Such patients report greater healthcare utilisation due to the greater impact of adverse symptoms. Manchester city region has the second highest admission rate for COPD in England, costing £16 million per year. In this setting, identification of potential research participants remains challenging. The targeted lung health check program (LHC) presents a potential opportunity for identification of undiagnosed COPD, as well as providing a window to engage with patients about the opportunities and potential benefits of participating in clinical research. Spirometry is a key criteria for screening into respiratory studies. Previously undertaken in Manchester as part of LHC, it was stopped during the Covid-19 pandemic. It has yet to be restarted, mainly due to inconsistency of onward management pathways. Published research suggests 10-20% of patients undergoing LHC have undiagnosed airflow obstruction. We propose cohorting such patients into research clinics, accurately diagnosing COPD and optimising management, enabling us to consent to future COPD studies.