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LOng COvid Multidisciplinary consortium Optimising Treatments and servIces acrOss the NHS (LOCOMOTION): protocol for a mixed-methods study in the UK.
Sivan, Manoj; Greenhalgh, Trisha; Darbyshire, Julie Lorraine; Mir, Ghazala; O'Connor, Rory J; Dawes, Helen; Greenwood, Darren; O'Connor, Daryl; Horton, Mike; Petrou, Stavros; de Lusignan, Simon; Curcin, Vasa; Mayer, Erik; Casson, Alexander; Milne, Ruairidh; Rayner, Clare; Smith, Nikki; Parkin, Amy; Preston, Nick; Delaney, Brendan.
  • Sivan M; Academic Department of Rehabilitation Medicine, University of Leeds, Leeds, UK m.sivan@leeds.ac.uk.
  • Greenhalgh T; Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
  • Darbyshire JL; Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
  • Mir G; Leeds Institute of Health Sciences, University of Leeds, Leeds, UK.
  • O'Connor RJ; Academic Department of Rehabilitation Medicine, University of Leeds, Leeds, UK.
  • Dawes H; College of Medicine and Health, University of Exeter, Exeter, UK.
  • Greenwood D; Leeds Institute for Data Analytics, University of Leeds, Leeds, UK.
  • O'Connor D; School of Psychology, University of Leeds, Leeds, UK.
  • Horton M; Academic Department of Rehabilitation Medicine, University of Leeds, Leeds, UK.
  • Petrou S; Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
  • de Lusignan S; Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
  • Curcin V; Department of Clinical and Experimental Medicine, University of Surrey, Guildford, UK.
  • Mayer E; Department of Primary Care and Public Health Sciences, King's College London, London, UK.
  • Casson A; Department of Biosurgery and Surgical Technology, Imperial College London, London, UK.
  • Milne R; Department of Electrical and Electronic Engineering, The University of Manchester, Manchester, UK.
  • Rayner C; Public Health, Wessex Institute, University of Southampton, Southampton, UK.
  • Smith N; Long Covid Support, Leeds, UK.
  • Parkin A; Long Covid Support, London, UK.
  • Preston N; Department of Occupational Therapy, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
  • Delaney B; Academic Department of Rehabilitation Medicine, University of Leeds, Leeds, UK.
BMJ Open ; 12(5): e063505, 2022 05 17.
Article in English | MEDLINE | ID: covidwho-1846526
ABSTRACT

INTRODUCTION:

Long COVID, a new condition whose origins and natural history are not yet fully established, currently affects 1.5 million people in the UK. Most do not have access to specialist long COVID services. We seek to optimise long COVID care both within and outside specialist clinics, including improving access, reducing inequalities, helping self-management and providing guidance and decision support for primary care. We aim to establish a 'gold standard' of care by systematically analysing current practices, iteratively improving pathways and systems of care. METHODS AND

ANALYSIS:

This mixed-methods, multisite study is informed by the principles of applied health services research, quality improvement, co-design, outcome measurement and learning health systems. It was developed in close partnership with patients (whose stated priorities are prompt clinical assessment; evidence-based advice and treatment and help with returning to work and other roles) and with front-line clinicians. Workstreams and tasks to optimise assessment, treatment and monitoring are based in three contrasting settings workstream 1 (qualitative research, up to 100 participants), specialist management in 10 long COVID clinics across the UK, via a quality improvement collaborative, experience-based co-design and targeted efforts to reduce inequalities of access, return to work and peer support; workstream 2 (quantitative research, up to 5000 participants), patient self-management at home, technology-supported monitoring and validation of condition-specific outcome measures and workstream 3 (quantitative research, up to 5000 participants), generalist management in primary care, harnessing electronic record data to study population phenotypes and develop evidence-based decision support, referral pathways and analysis of costs. Study governance includes an active patient advisory group. ETHICS AND DISSEMINATION LOng COvid Multidisciplinary consortium Optimising Treatments and servIces acrOss the NHS study is sponsored by the University of Leeds and approved by Yorkshire & The Humber-Bradford Leeds Research Ethics Committee (ref 21/YH/0276). Participants will provide informed consent. Dissemination plans include academic and lay publications, and partnerships with national and regional policymakers. TRIAL REGISTRATION NUMBER NCT05057260, ISRCTN15022307.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Prognostic study / Qualitative research / Randomized controlled trials Topics: Long Covid Limits: Humans Country/Region as subject: Europa Language: English Journal: BMJ Open Year: 2022 Document Type: Article Affiliation country: Bmjopen-2022-063505

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Prognostic study / Qualitative research / Randomized controlled trials Topics: Long Covid Limits: Humans Country/Region as subject: Europa Language: English Journal: BMJ Open Year: 2022 Document Type: Article Affiliation country: Bmjopen-2022-063505