Can shared medical appointments in general practice support people living with chronic obstructive pulmonary disease in the North East and North Cumbria region of England?

INTERVENTION: Participants will be randomly allocated to attend a shared appointment in‐person or by video link, or receive usual care. The researchers will: 1. Measure the number of patients that take part and remain in the study 2. Interview patients about experiences in the study 3. Test how to collect information from patients about NHS use 4. Interview staff about how well shared appointments work 5. Test how to collect information about the time and money needed to run SMAs 6. Use their findings to decide if a larger trial is possible A number generator will be used to randomize the patients in a ratio of 1:1:1 to either the in‐person SMA arm, video SMA arm or usual care arm of the trial using variable length random permuted blocks within strata. Participants randomized to the treatment arms will attend a single, 90‐minute shared medical appointment delivered by a team of staff from participating primary care practices. Participants allocated to receive usual care (control arm) will receive no additional intervention. Usual care typically includes an annual review delivered 1:1 in person, pulmonary rehabilitation (if appropriate) and primary and secondary care treatment for exacerbations. Primary care visits tend to be 1:1 appointments with the nurse practitioner/ pharmacist that last 10‐15 minutes. It is also possible that they may be referred, or self‐refer, to attend a 1:1 appointment with a social prescribing link‐worker. Follow‐up will occur approximately 6 months from baseline (3 months post intervention) and again at 12 months from baseline (9 months post intervention.) This will involve the c CONDITION: Chronic obstructive pulmonary disease ; Respiratory ; Other chronic obstructive pulmonary disease PRIMARY OUTCOME: ; 1. Recruitment rates measured using screening logs at end of the recruitment period; 2. Retention and attrition rates i.e. the proportion of participants that attend the PSMA/VSMA and the proportion of participants that return and complete questionnaires at 6 and 12 months; 3. Completion rates of study questionnaires and proformas (including those to collect economic data):; 3.1. Knowledge, skills and confidence to manage their own health and wellbeing measured by Patient Activation Measure at baseline, 3 months post‐intervention and 9 months post‐intervention; 3.2. Anxiety and depression symptoms measured using Health, Anxiety and Depressions Scale at baseline, 3 months post‐intervention and 9 months post‐intervention; 3.3. Quality of life measured using EQ‐5D‐5L at baseline, 3 months post‐intervention and 9 months post‐intervention; 3.4. Healthcare service use measured by Patient care use questionnaire at baseline, 3 months post‐intervention and 9 months post‐intervention; 3.5. Healthcare service use measured by screening logs and case report form at 12 months; 3.6. Time and travel costs measured using Patient Time and Travel questionnaire at 1 month post‐intervention; 3.7. Primary care costs (staff time and consumables) measured using resource use proforma within 2 weeks of the intervention; INCLUSION CRITERIA: 1. Aged 18 years or older with a diagnosis of COPD 2. Under ongoing management in general practice 3. Able to give informed consent SECONDARY OUTCOME: Acceptability and feasibility of SMAs and study processes: willingness to enter the trial, the acceptability of the study design, attendance at the SMAs and acceptability of the PAM questionnaire as the proposed outcome measure, collected by qualitative interviews with patient participants and interventionists within 8 weeks of the intervention