• This project will commence in September 2017 and run for 15 months.
  • Run by Royal Liverpool and Broadgreen University Hospitals NHS Trust, with 2Bio Ltd, an innovation specialist, Liverpool Clinical Commissioning Group and Addaction, a drug and alcohol treatment charity.
  • To be implemented with Addaction clients in Liverpool.
  • Aiming to reduce hospital admissions for heroin users who have developed chronic obstructive pulmonary disease (COPD).
  • Will facilitate access to existing community COPD services by improving communication and engagement with this hard-to-reach population.

Heroin users are likely to have undiagnosed chronic obstructive pulmonary disease (COPD) and are at an increased risk of hospital admission with advanced disease. In Liverpool, more than three quarters of the substance misuse service users that died in 2016 had COPD or pneumonia listed as their cause of death.

COPD is diagnosed by a simple breathing test (spirometry), arranged by a patient’s GP or performed as an outpatient in a secondary care clinic. However, heroin users engage poorly with primary care and rarely attend secondary care follow-up. This leads to late diagnosis and missed opportunities to stop smoking and slow disease progression.

The point at which they do consistently engage with health care is at the methadone clinic via their drug key worker.

This project will involve facilitating access to existing community COPD services for heroin smokers in Merseyside. The intervention will be supervised by a secondary care respiratory consultant and coordinated by Addaction, a drug and alcohol treatment charity.

Appointments will be tied as closely as possible to the methadone clinic timings, and Liverpool Clinical Commissioning Group will move the currently commissioned community COPD services closer to the methadone clinics for a trial period.

Information will be disseminated at Addaction sites to highlight the problem of COPD and heroin smoking, and to encourage clients to seek help for any respiratory problems.

The project team is aiming to intervene early with heroin users with COPD, and therefore slow disease progression and reduce morbidity, including the need for acute secondary care intervention.