Patient experience of community-based asthma & COPD management in an integrated care hub.

Asthma & COPD are the most common chronic respiratory diseases worldwide, causing significant morbidity and mortality and account for almost 40% of respiratory outpatient waiting lists in Ireland. Recent changes in care pathways in Ireland have led to the development of an enhanced community care model, providing community-based specialist programs to support chronic disease management by general practitioners (GP). The Wicklow Respiratory Integrated Care (RIC) hub began full operations in 2023, providing community-based integrated asthma/COPD supports including nurse specialist (CNS) clinics, pulmonary physiology (PFTs), pulmonary rehabilitation (PR),to a population of ~200,000. <bold>Aims:</bold> We surveyed all patients who attended our RIC service in 2023 to explore user experience and attitudes towards this novel care pathway. <bold>Methods:</bold> All service users from 2023 were sent a web-link to a custom survey by SMS-message. <bold>Results:</bold> 64/520 completed the survey (12.9%). 88% were extremely satisfied with their experience compared to prior expectations of the health care services. In responders who had experienced both hospital outpatient & integrated community care, <5% preferred the hospital system. Overall satisfaction was high for PFT, CNS, & PR services (Net Promoter Score 94.7, 97.1 and 87.5 respectively). 90% were equally or more satisfied with the idea of GP-led integrated community care as compared to long-term scheduled specialist reviews. <bold>Conclusion:</bold> Patients receiving integrated respiratory community-based care for asthma & COPD reported high levels of satisfaction and a general preference for community based chronic disease management rather than hospital-based outpatient care.