Pragmatic Trial to Enhance Quality Safety, and Patient Experience in COPD

NCT ID: NCT05718102

Last Updated: 2026-01-20

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

4000 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-05-15

Study Completion Date

2027-01-01

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

Background: Over 26 million Americans have chronic obstructive pulmonary disease (COPD), which is the third leading cause of death in the United States. Unfortunately, few patients receive proven therapies and many receive therapies known to have safer alternatives. One major reason is the competing demands of primary care providers (PCPs) who manage 90% of patients with COPD. The research team has developed a population management approach where pulmonary specialists provide evidence-based recommendations as an E-consult with unsigned orders to PCPs. PCPs can then quickly review the E-consult and sign, modify, or discontinue these orders. The investigators found this intervention led to marked improvements in the quality-of-care delivered and patients' COPD-related quality-of-life. While promising, this approach is limited by a paucity of pulmonary providers nationwide. Clinical pharmacists are 20 times more prevalent as pulmonary specialists and some regions of VA (VISN 17, COPD Cares) have assigned clinical pharmacists a role in the management of patients with COPD. However, the relative effectiveness of pharmacist-led management is yet to be established.

Study Description: This study tests population management for COPD provided by pharmacists relative to pulmonary specialists. The investigators are conducting a cluster randomized clinical trial at five medical centers and their associated clinics within the Department of Veterans Affair. Study staff will randomize PCPs to population management conducted by either pulmonary specialists or pharmacists. Within PCPs' panels, study staff will use VA electronic health record to identify patients with evidence of COPD. Pulmonologists and pharmacists will review these patients and provide guideline-based recommendations to PCPs. Pulmonary specialists and pharmacists will then deliver evidence-based recommendations through E-consults coupled with unsigned orders for primary care providers to sign, modify or decline.

Outcomes: Investigators will assess if proactive, population management recommendations by clinical pharmacists and pulmonary specialists lead to non-inferior outcomes for patients with COPD. The primary outcome will be a composite endpoint of COPD exacerbation, pneumonia, hospitalization, or death six month after intervention. Secondary outcomes will include 1) the proportion of guideline recommended therapies received by patients, 2) COPD-related quality-of-life as measured by the Clinical COPD Questionnaire, and 3) PCP acceptance of recommendations, 4) each individual outcome within the primary composite endpoint above, and 5) patient- and caregiver-incurred costs.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Pulmonary Disease, Chronic Obstructive

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Pharmacist led

Pharmacists will conduct population health management for patients with COPD

Group Type ACTIVE_COMPARATOR

Population-health management

Intervention Type OTHER

Population-health management

Pulmonologist led

Pulmonologists will conduct population health management for patients with COPD

Group Type ACTIVE_COMPARATOR

Population-health management

Intervention Type OTHER

Population-health management

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

Population-health management

Population-health management

Intervention Type OTHER

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* Participants may be PCP physicians and advance practice providers (APP) practicing at participating sites, and their patients who are diagnosed with or treated for COPD based on the following criteria:

1. Recent discharge from hospital for COPD exacerbation
2. Recent outpatient exacerbation (emergency room (ER), primary care)
3. Received prescription for an inhaled corticosteroid (ICS) but does not meet criteria for ICS use
4. Diagnosis of COPD and/or treatment and active smoker not receiving smoking cessation aide
5. Treatment for COPD without evidence of spirometry within 10 years, or no airflow obstruction on existing spirometry
Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

Patient-Centered Outcomes Research Institute

OTHER

Sponsor Role collaborator

Seattle Institute for Biomedical and Clinical Research

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Responsibility Role SPONSOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Lucas M Donovan, MD

Role: PRINCIPAL_INVESTIGATOR

VA Puget Sound Health Care System

David H Au, MD

Role: PRINCIPAL_INVESTIGATOR

VA Puget Sound Health Care System

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Minneapolis VA Health Care System

Minneapolis, Minnesota, United States

Site Status RECRUITING

Portland VA Medical Center

Portland, Oregon, United States

Site Status RECRUITING

Ralph H. Johnson VA Medical Center

Charleston, South Carolina, United States

Site Status RECRUITING

VA Puget Sound Health Care System

Seattle, Washington, United States

Site Status RECRUITING

Mann-Grandstaff VA Medical Center

Spokane, Washington, United States

Site Status RECRUITING

Countries

Review the countries where the study has at least one active or historical site.

United States

Central Contacts

Reach out to these primary contacts for questions about participation or study logistics.

Jennifer A McDowell, MS

Role: CONTACT

206.277.1139

Emily E Gleason

Role: CONTACT

206.277.6739

Facility Contacts

Find local site contact details for specific facilities participating in the trial.

Jennifer A McDowell, MS

Role: primary

206.277.1139

Jennifer A McDowell, MS

Role: primary

206.277.1139

Jennifer A McDowell, MS

Role: primary

206.277.1139

Jennifer A McDowell, MS

Role: primary

206.277.1139

Jennifer A McDowell, MS

Role: primary

206.277.1139

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

PCORI-23668

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.

Walk On! Physical Activity Coaching
NCT02478359 COMPLETED NA
Evaluation of COPD Co-Pilot
NCT03018847 UNKNOWN