Objectives

Primary Objective

To determine whether the addition of a CRP POCT (with training on test use and interpretation) to current best practice based on NICE guideline for managing an AECOPD leads to a reduction in antibiotic consumption within four weeks post index consultation without negatively impacting on patient recovery (measured at two weeks post index consultation), compared with current best practice alone.

Secondary objectives

To assess the effect of using a CRP POCT for AECOPD in primary care on:

  1. Prevalence of resistant bacteria in sputum and throat swab samples at 4 weeks;
  2. COPD health status over time (weeks 1, 2 and 4);
  3. Health utility, measured using the EQ-5D-5L at 1, 2 and 4 weeks and at 6 months;
  4. All cause antibiotic consumption during the first four weeks
  5. Antibiotic prescribing at the index consultation;
  6. Use of other COPD treatments including oral steroids during the first four weeks;
  7. Adverse effects from antibiotics and other medication prescribed for their AECOPD during the first four weeks;
  8. Primary and secondary care consultations (including out of hours, A&E visits and hospitalisations) during the subsequent 6 months;
  9. Costs and cost-effectiveness from a health service perspective;
  10. Incidence of pneumonia during the first 4 weeks and from the 4-week follow up to 6 months;
  11. Disease-specific HRQoL (CRQ-SAS) at 6 months.