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dc.contributor.authorYakutcan, Usame
dc.contributor.authorHurst, John R.
dc.contributor.authorLebcir, Reda M.
dc.contributor.authorDemir, Eren
dc.date.accessioned2023-09-27T09:15:01Z
dc.date.available2023-09-27T09:15:01Z
dc.date.issued2022-10-07
dc.identifier.citationYakutcan , U , Hurst , J R , Lebcir , R M & Demir , E 2022 , ' Assessing the impact of COVID-19 measures on COPD management and patients: A simulation-based decision support tool for COPD services in the UK ' , BMJ Open , vol. 12 , no. 10 , e062305 , pp. 1-8 . https://doi.org/10.1136/bmjopen-2022-062305
dc.identifier.issn2044-6055
dc.identifier.otherORCID: /0000-0002-9648-5529/work/143285588
dc.identifier.urihttp://hdl.handle.net/2299/26759
dc.description© 2022 The Author(s) or their employer(s). Published by BMJ. This is an open access article under the CC BY-NC-ND licence, https://creativecommons.org/licenses/by-nc-nd/4.0/
dc.description.abstractObjectives To develop a computer-based decision support tool (DST) for key decision makers to safely explore the impact on chronic obstructive pulmonary disease (COPD) care of service changes driven by restrictions to prevent the spread of COVID-19.  Design The DST is powered by discrete event simulation which captures the entire patient pathway. To estimate the number of COPD admissions under different scenario settings, a regression model was developed and embedded into the tool. The tool can generate a wide range of patient-related and service-related outputs. Thus, the likely impact of possible changes (eg, COVID-19 restrictions and pandemic scenarios) on patients with COPD and care can be estimated.  Setting COPD services (including outpatient and inpatient departments) at a major provider in central London.  Results Four different scenarios (reflecting the UK government's Plan A, Plan B and Plan C in addition to a benchmark scenario) were run for 1 year. 856, 616 and 484 face-to-face appointments (among 1226 clinic visits) are expected in Plans A, B and C, respectively. Clinic visit quality in Plan A is found to be marginally better than in Plans B and C. Under coronavirus restrictions, lung function tests decreased more than 80% in Plan C as compared with Plan A. Fewer COPD exacerbation-related admissions were seen (284.1 Plan C vs 395.1 in the benchmark) associated with stricter restrictions. Although the results indicate that fewer quality-adjusted life years (in terms of COPD management) would be lost during more severe restrictions, the wider impact on physical and mental health must also be established.  Conclusions This DST will enable COPD services to examine how the latest developments in care delivery and management might impact their service during and beyond the COVID-19 pandemic, and in the event of future pandemics.en
dc.format.extent8
dc.format.extent555880
dc.language.isoeng
dc.relation.ispartofBMJ Open
dc.subjectsimulation
dc.subjectCOVID-19
dc.subjectCOPD
dc.subjectQALYs
dc.subjectpatient outcomes
dc.subjectDecision support system
dc.subjecthealth policy
dc.subjectchronic airways disease
dc.subjectrespiratory medicine (see thoracic medicine)
dc.subjectrespiratory infections
dc.subjectPandemics
dc.subjectHumans
dc.subjectUnited Kingdom/epidemiology
dc.subjectPulmonary Disease, Chronic Obstructive/complications
dc.subjectCOVID-19/epidemiology
dc.subjectQuality of Life
dc.subjectGeneral Medicine
dc.titleAssessing the impact of COVID-19 measures on COPD management and patients: A simulation-based decision support tool for COPD services in the UKen
dc.contributor.institutionHertfordshire Business School
dc.contributor.institutionCentre for Future Societies Research
dc.contributor.institutionStatistical Services Consulting Unit
dc.description.statusPeer reviewed
dc.identifier.urlhttp://www.scopus.com/inward/record.url?scp=85139570469&partnerID=8YFLogxK
rioxxterms.versionofrecord10.1136/bmjopen-2022-062305
rioxxterms.typeJournal Article/Review
herts.preservation.rarelyaccessedtrue


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