NCT07460154

Brief Summary

Background: Chronic obstructive pulmonary disease (COPD) is a serious lung condition and the third leading cause of death worldwide. People with COPD have sudden and distressing flare-ups (exacerbations). These can be triggered by infections or occur without a clear cause. Flare-ups often lead to hospital admission, can cause a lasting health decline, increase the risk of dying and are strongly liked to lower income. Sometimes, people are wrongly diagnosed with COPD, when they have a different health issue. Other diseases (like heart conditions) are common in people with COPD, and share similar symptoms. These have often not been diagnosed and worsening of these conditions can look like a flare-up of COPD, leading to incorrect treatment. Additionally, many people with COPD have not been offered appropriate treatments that would reduce their flare-up frequency. COPD flare-ups are treated with steroid tablets (prednisolone), and sometimes antibiotics. Frequent use of prednisolone causes side effects such as weight gain, bone thinning (osteoporosis) and diabetes. Reducing how often people with COPD have flare-ups can reduce these side effects. The investigators aim to reduce COPD flare-ups and prevent harm from prednisolone by improving the treatment of COPD, while also checking for other health conditions. The goal: In people with COPD, who take prednisolone for flare-ups (three of more times a year), the investigators want to see if a thorough assessment (that focuses on the treatment of COPD and diagnosis of other common health problems), reduces the number of flare-ups that need prednisolone over the next year. Design: Participants will attend a half-day hospital visit for a thorough check-up (a mini-MOT). The assessment includes a review by a doctor, questionnaires, blood tests, breathing tests, a scan of the chest (CT), and investigations on the heart. The investigators will make sure participants receive the correct treatment for their COPD. The assessment will focus on three areas: lung health, identifying and treating important health issues outside of the lungs (that may be contributing or causing symptoms similar to COPD) and supporting changes in behaviours that can improve lung health. These factors (whether in the lungs, body or related to lifestyle) are known as treatable traits. The investigators will also review participants prednisolone use and check for health problems that may have been caused by it. At the end of the assessment participants will be given a personalised treatment plan. Participants will be followed up for 12 months, at 3 month intervals. During this time they will collect information on the number of emergency hospital visits, serious heart-related events, steroid tablets taken for COPD flare-ups and any deaths. They will ask participants to complete short questionnaires about their health and wellbeing. Who provided advise on this study : Preventing COPD flare-ups is a top priority, identified by The James Lind Alliance (a national research priority setting partnership). This study was reviewed by the Northumbria Lung Research Patient Advisory Group (people living with COPD). They felt the study was well-designed and likely to make a meaningful difference. People with experience in research and COPD also gave feedback, and changes were made, such as reducing travel requirements, based on their views. The research team has successfully completed studies that have led to real improvement in COPD care, and are committed to ensuring this study has a similar positive impact. Sharing results: At the end of the study results will be shared with the public, study participants, healthcare workers, commissioners and guideline advisory groups. The findings will be shared on online platforms, present them at national/international conferences, and published in medical journals. The aim is to ensure findings improve clinical practice, policies and guidelines.

Trial Health

77
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
96

participants targeted

Target at P50-P75 for not_applicable

Timeline
34mo left

Started Mar 2026

Typical duration for not_applicable

Geographic Reach
1 country

1 active site

Status
recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

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Study Timeline

Key milestones and dates

Study Progress7%
Mar 2026Mar 2029

First Submitted

Initial submission to the registry

December 11, 2025

Completed
3 months until next milestone

First Posted

Study publicly available on registry

March 10, 2026

Completed
1 day until next milestone

Study Start

First participant enrolled

March 11, 2026

Completed
3 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

March 2, 2029

Expected
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

March 2, 2029

Last Updated

April 23, 2026

Status Verified

June 1, 2025

Enrollment Period

3 years

First QC Date

December 11, 2025

Last Update Submit

April 20, 2026

Conditions

Keywords

COPDStructured assessmentTreatable TraitComplex InterventionExacerationSteroidOral CorticosteroidComorbidityMultimorbity

Outcome Measures

Primary Outcomes (1)

  • Cumulative dose of oral prednisolone over 12-months*. * excluding short courses of prednisolone prescribed for conditions not related to airway exacerbations (e.g. anaphylaxis, inflammatory bowel disease, cutaneous skin disorders).

    12 months (commencing 8 weeks after structured assessment complete). Measured at 5, 8, 11 and 14 months from enrolment.

Secondary Outcomes (23)

  • Proportion of participants with confirmed COPD (based on spirometry and clinical assessment).

    From enrolment to end of structured assessment (week 1)

  • Distribution of COPD by severity, endotype and phenotype.

    From enrolment to end of structured assessment (week 1)

  • Proportion of participants receiving new or adjusted COPD-specific treatments.

    From enrolment to review of investigation outcomes and adherence (week 8)

  • Proportion of participants with each comorbidity, stratified by whether the condition was previously recognised or newly identified.

    From enrolment to review of investigation outcomes and adherence (week 8)

  • Number of new treatments initiated (per participant), both overall and by specific therapy (class/ type), started as result of the multidimensional assessment

    Last subject, 8 week review

  • +18 more secondary outcomes

Study Arms (1)

Structured Health Assessment

ACTIVE COMPARATOR

Structured Health Assessment 1. Confirm (or exclude) the COPD diagnosis and measure study outcomes 2. Identify and treat pulmonary, extra-pulmonary and modifiable behaviour traits 3. Perform a comprehensive multi-morbidity assessment 4. Deliver targeted educational interventions

Diagnostic Test: Sputum sampleDiagnostic Test: VenepunctureDiagnostic Test: Lung function testDiagnostic Test: Medical history and physical examinationDiagnostic Test: Blood pressureDiagnostic Test: BMIRadiation: HRCT of chestDiagnostic Test: ECGDiagnostic Test: EchoDiagnostic Test: Subject QuestionnairesDiagnostic Test: Research QuestionnairesBiological: Influenza VaccinesBiological: Pneumococcal VaccineBiological: RSV F vaccine (0.5mL injection)Diagnostic Test: Oxygen saturation (+/- ABG)Radiation: DXABehavioral: Education

Interventions

Sputum sampleDIAGNOSTIC_TEST

Sputum sample

Structured Health Assessment
VenepunctureDIAGNOSTIC_TEST

FBC, Total IgE, Corrected Calcium, Vitamin D, Liver function test, Early morning cortisol, HbA1C, NT pro BNP, Lipid panel, U\&E

Structured Health Assessment
Lung function testDIAGNOSTIC_TEST

Spirometry, FENO +/- Gas transfer, body plethysmography

Structured Health Assessment

Medical history and physical examination

Structured Health Assessment
Blood pressureDIAGNOSTIC_TEST

Blood pressure

Structured Health Assessment
BMIDIAGNOSTIC_TEST

Weight and height Waste and hip circumference

Structured Health Assessment
HRCT of chestRADIATION

HRCT of chest (Strat X protocol) with coronary artery caclium score

Structured Health Assessment
ECGDIAGNOSTIC_TEST

Electrocardiogram

Structured Health Assessment
EchoDIAGNOSTIC_TEST

Echocardiogram

Structured Health Assessment

For those eligible under usual standard of care

Structured Health Assessment

Resting oxygen saturation on room air (+/- ABG)

Structured Health Assessment
DXARADIATION

Participants with a high or intermediate FRAX® risk score, or those aged \>50 years with a history of fragility fractures, will be offered a dual-energy x-ray absorptiometry scan (DXA)

Structured Health Assessment
EducationBEHAVIORAL

Education on Inhaler Technique, Medication Adherence, Tobacco \& Substance Abuse, Physical Activity, and COPD Self Management

Structured Health Assessment
Subject QuestionnairesDIAGNOSTIC_TEST

Clinical questionnaires: ESS, FRAX score, QRISK4,

Structured Health Assessment

Research questionnaires: eMRCD, SQRQ-C, EQ-5D-5L, HADS-A, HADS-D, Seven step inhaler technique, PIH scale

Structured Health Assessment

For those eligible under usual standard of care

Structured Health Assessment

For those eligible under usual standard of care

Structured Health Assessment

Eligibility Criteria

Age35 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • COPD diagnosis documented in primary care records for at least 12 months.
  • Age 35 years or older
  • or more prednisolone prescriptions in the past 12-months for ECOPD\*
  • Capacity to give informed consent
  • Clinically stable at study entry (≥4 weeks following last ECOPD or other significant acute illness) \* each prednisolone course separated by a minimum of 14 days from completion of the previous course.

You may not qualify if:

  • Maintenance OCS use currently or within the past 12 months \*
  • Anticipated inability to comply with the protocol
  • Illness limiting life expectancy to less than 12 months (other than COPD)
  • Housebound
  • Lung transplant
  • Domiciliary non-invasive ventilation \*defined as ≥10mg daily for ≥ 6 weeks

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Northumbria NHS Foundation Trust

North Shields, United Kingdom

RECRUITING

MeSH Terms

Conditions

Pulmonary Disease, Chronic Obstructive

Interventions

Blood Specimen CollectionRespiratory Function TestsPhysical ExaminationBlood PressureElectrocardiographyCavesInfluenza VaccinesPneumococcal VaccinesInjectionsOxygen SaturationBlood Gas AnalysisEducational Status

Condition Hierarchy (Ancestors)

Lung Diseases, ObstructiveLung DiseasesRespiratory Tract DiseasesChronic DiseaseDisease AttributesPathologic ProcessesPathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

Specimen HandlingClinical Laboratory TechniquesDiagnostic Techniques and ProceduresDiagnosisPuncturesSurgical Procedures, OperativeInvestigative TechniquesDiagnostic Techniques, Respiratory SystemVital SignsHemodynamicsCardiovascular Physiological PhenomenaCirculatory and Respiratory Physiological PhenomenaHeart Function TestsDiagnostic Techniques, CardiovascularElectrodiagnosisGeological PhenomenaPhysical PhenomenaEnvironmentEcological and Environmental PhenomenaBiological PhenomenaEnvironment and Public HealthViral VaccinesVaccinesBiological ProductsComplex MixturesStreptococcal VaccinesBacterial VaccinesDrug Administration RoutesDrug TherapyTherapeuticsMetabolismBlood Chemical AnalysisClinical Chemistry TestsSocioeconomic FactorsPopulation Characteristics

Study Officials

  • Ruth E Sobala, MBBS

    Northumbria Healthcare Foundation NHS Trust

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Study Design

Study Type
interventional
Phase
not applicable
Allocation
NA
Masking
NONE
Purpose
DIAGNOSTIC
Intervention Model
SINGLE GROUP
Model Details: A stepped wedge cluster randomisation with continuous recruitment. Within-subject control to compare primary and secondary outcomes between study entry and study end will be used. This has been chosen to minimise bias as the components of the intervention (multidimensional assessment) are available through usual care, and subsequent treatment will be by standard guidelines. Individual stepped wedge design will allow each patient to act as their own control, thus increasing statistical power, whilst helping to control for confounders such as variation in general practice care. Patient allocation to scheduled assessments will ensure balanced entry across seasons and between years. Compared to a cluster design, contamination at practice level will be limited as the intervention is patient-specific.
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

December 11, 2025

First Posted

March 10, 2026

Study Start

March 11, 2026

Primary Completion (Estimated)

March 2, 2029

Study Completion (Estimated)

March 2, 2029

Last Updated

April 23, 2026

Record last verified: 2025-06

Data Sharing

IPD Sharing
Will not share

Locations