AD HOC is a five-year research programme, which started in March 2022. The overall aim of the research is to find out whether an intervention delivered through primary care, to encourage engagement with the Asthma UK online health community, can improve asthma symptoms and quality of life for patients with troublesome asthma. In the first part of the study, we are seeking the input and feedback of asthma patients, GPs and practice nurses on the design of the study intervention and the survey that will be used to recruit patients. Once these are finalised, we will test the survey and intervention in a feasibility study with a small number of GP surgeries.
If your surgery is taking part or you have been invited to take part in a one-to-one interview you find out more on our Resources page If you have any questions, you can contact the research team at ADHOC@qmul.ac.uk
AD HOC is a five-year research programme designed to test the hypothesis that primary care can promote engagement in the Asthma UK online health community to improve asthma control and quality of life, with the following objectives:
The full title of the programme is: Effectiveness and cost-effectiveness of A Digital social intervention for people with troublesome astHma prOmoted by primary care Clinicians.
Of 4.3 million adults living with asthma in the UK, up to one third experience suboptimal control. Poor asthma control has major impacts: 93,000 people are hospitalised annually, with 121,000 A&E visits and 6.3 million primary care consultations/year. Asthma costs the UK £1.1bn/year. UK asthma mortality is amongst the worst in Europe. Digital social interventions are novel in healthcare and have potential to impact health on a large scale, for example, NHS Digital Facebook groups to promote cancer screening. Evidence of effectiveness is sparse and robust large-scale evaluations are needed. Online health communities (OHCs) now exist for asthma and many other long-term conditions. We have shown that accessing an online asthma OHC facilitates inhaler taking. This is mediated through a core of very active users, 'superusers' in the Asthma UK OHC, who are highly motivated lay individuals who exhibit judgment about the complexity of coping with asthma and the limits of their advice. The rapid move to online healthcare provides a timely context in which to test whether primary care can promote engagement with OHCs.
The AD HOC programme is funded by the National Institute for Health Research Programme Grants for Applied Research Programme (Project Reference Number NIHR202037
We will be working with Noclor, the local Clinical Research Network (CRN) to invite GP surgeries in East and North London to take part. Participating surgeries will invite patients registered with them who have asthma. We are also inviting some of the general practice staff to contribute to the research.
The study sponsor is the Joint Research Management Office at Queen Mary University of London. The preliminary phases of the AD HOC programme (referred to in these FAQs as parts one, two and three) have received approval from the NHS Health Research Authority on 04 October 2022 (REC reference 22/NE/0182, IRAS project ID 314672). Please note, ethical approval has not yet been sought for the full trial; this will be applied for subsequent to completion of the feasibility trial.
There are several parts to the AD HOC study. In the first part, we are asking asthma patients, GPs and nurses for their input and feedback on design of the intervention and the recruitment survey. This will involve around 30 patients from 3 GP surgeries. We will invite the patients to a focus group, to be held at each surgery, and conduct a one-to-one interview with a GP and a practice nurse from each surgery.In the second part, we will recruit up to 6 GP surgeries, who will invite all their registered asthma patients (via SMS) to take part in a survey about asthma symptoms, quality of life and online health communities. The survey will include an invitation to take part in the intervention.
In the third part, patients who said they would like to take part in the intervention will attend the surgery for a consultation with the practice nurse, for delivery of the intervention (providing a login for the Asthma UK online health community and explaining to them how they can engage with it). After 6 months, the patients will be sent a follow-up questionnaire (via SMS) about their asthma symptoms, quality of life and engaging with the online health community. This will involve about 50 patients in total.
If these 3 preliminary phases go well, then we will proceed to a full randomised trial of the intervention, involving recruitment of 50 GP surgeries. The survey will be sent to all registered asthma patients, and from among these, patients who say they would like to take part will attend for a consultation, which will be randomised to intervention delivery or normal care. Patients will be sent a follow-up questionnaire after 12 months. This trial will involve about 500 patients (with the survey being sent to approximately 30,000).
Surgeries will receive compensation according to current guidelines and NHS costs. Patients participating in the focus groups or the feasibility or actual trial, as well as GPs and nurses participating in one-to-one interviews, will receive a £30 supermarket voucher. Patients completing the online survey will not be compensated.
In part one, we will make an audio recording of focus groups and one-to-one interviews and will take the feedback and ideas from these to finalise the intervention and survey design. GP surgeries will make the initial contact with patients, who will be asked to provide their contact information, in order that we can arrange their participation in the focus groups. Our contact at each GP surgery will be asked to provide the email addresses of a GP and practice nurse who are willing to be interviewed. Participant details will not be used other than to arrange the focus groups/interviews, and will not be retained.
In part two, GP surgeries will send the survey to all patients on the asthma registry. The survey will include questions on asthma symptoms, quality of life and online health communities, as well as personal characteristics, such as gender, age group, and ethnic background. No personal identifiable information (e.g. name, contact details) will be requested and the researchers will not be able to identify any individual respondents.
For part three, patients who would like to participate in the intervention will need to provide their contact information, in order for them to be contacted about taking part, but this will not be retained beyond the duration of the study. The intervention and the 6-month follow up will include questions about their asthma symptoms, quality of life and engaging with the online health community.
AD HOC is led by researchers from the Wolfson Institute of Population Health at Queen Mary University of London, with collaborators from the University of Cambridge, University of Nottingham, City University London, University of Surrey, and St George’s University of London, our charity partner Asthma + Lung UK, and our industry partner HealthUnlocked.
Find out more about our research team based at Queen Mary University of London
When each part of the study is completed, we will publish/present the results in academic journals/conferences and on appropriate media outlets, so that other researchers or interested parties can see them. We will be adding updates on study progress and any publications to the News and Events <hyperlink> page of our website. Please note that no individual participant will be identifiable in any presentations or published material stemming from this study.