GENIE in COPD by Lindsay Welch
Self-Management Support (SMS) is increasingly seen as relevant to supporting people to manage their Chronic Obstructive Pulmonary Disease (COPD) but no one intervention is wholly successful in COPD. Adding a social network approach may deliver positive outcomes. The concept of supportive self-management draws on the capacity of improved social networks to pull on a broader set of resources, to elicit peer support and to have meaningful connections through community-based resources. A social network tool GENIE (Generating Engagement in Networks) was adapted for use in COPD and implemented in a community care context.
Southampton has a high a rising prevalence of COPD, with marked pockets of deprivation. The need for ongoing community care is out-weighing capacity in local pulmonary rehabilitation groups and follow on exercise groups.
Genie is COPD was a feasibility study aimed to evaluate quality of life, COPD disease burden and health care utilisation in COPD patients using the GENIE tool. A nutritional component, and a process evaluation was nested in this feasibility work.
Clinical results indicate clinical stability in CAT, GAD and PHQ-9 with improvements in terms of cost to the NHS and quality of life for patients. Health utilisation costs dropped by 40% in the intervention group and dropped by 0.64% in the control arm. Quality of life increased in the intervention group by 11.1%, decreased in the control group by 6.66% (n=60). Prudent diet score were preserved in the intervention group and decreased in the control arm (n=30).
The intervention was delivered limited by size and recruitment timelines. However, the study was a successful feasibility study, highlighting the potential to use social networking support as a supportive self-management tool in reducing COPD disease burden on formal care. The study would have benefitted from qualitative enquiry, but this element was not ethically approved. Further analysis of patient self-confidence in managing their health conditions after using Genie and after acquiring their community support should be investigated.
Publication and links
This work in under review for publication.
New Approach- Social networking and peer support as a SMS intervention. Genie has been adopted by Southampton city CCG and can be viewed and used via the links below.
https://southampton.genie-net.org/eng/
The tool is designed to open conversations using a concentric circle model - regarding social networks. Then to elicit support either through existing networks, or by formation of new networks, and develop a reciprocal approach.
Biography
Lindsay currently holds the post for clinical lead of long-term conditions within Solent NHS Trust and is a doctoral researcher in the Faculty of Environmental and life Sciences, School of Health Science at the University of Southampton. She has been a respiratory nurse for 18 years, and worked across primary care, acute care, research delivery, community nursing and pulmonary rehabilitation. Currently her interests lie in chronic obstructive Pulmonary Disease, and she was privileged to lead the Integrated COPD service for 4 years. During this time she has led to a successful bid with the service to the Queens Nursing Institute to develop a sustainable Singing in COPD project. Also funding to integrate the BLF into the clinical service. She has developed, implemented and evaluated a clinical tool to work with low activated COPD patients (PAM level 1) within the COPD service. She currently works in nurse led community clinics for respiratory patients. Lindsay is interested in the development of complex consultation skills in clinical practice. She is currently researching self-management in COPD, and exploring if socially supported and peer group methods promote behaviour change in the population. Her broader academic interests include; behaviour change interventions in long term conditions and process evaluation in intervention implementation.