COPD awareness

The South Tyneside Love Your Lungs campaign sought to raise awareness of the signs and symptoms of COPD to encourage early diagnosis among at-risk groups, and reduce future emergency hospital admissions.

The campaign ran in South Tyneside in January and February 2009.

The strategy

In 2007 one of the British Lung Foundation’s key objectives was to identify the estimated 2.8 million people in the UK who have COPD and are undiagnosed.

The BLF wanted to use a robust quantitative approach to find the “missing millions”. The key priority of the project was to build a segmentation of the population that worked on the dual axis of:

• stratifying the population by their risk of having COPD
• segmenting the population by their lifestyle types and preferred communications channels

The balance between these two elements was considered key to a long term business objective of the BLF of prioritising which areas of the country they should focus their resources on, and a short term tactical aim of running targeted social marketing campaigns in key primary care trusts. This analysis, stratification and segmentation formed the basis of the Invisible Lives report.

To create the report an external supplier was commissioned to combine hospital admissions data and lifestyle data to create a sophisticated model that estimates how many people in each PCT area are at risk of having COPD.

This model was independently evaluated by Richard Hubbard, resident professor of epidemiological and respiratory research from the Centre for Respiratory Research, Nottingham University, to ensure it was fit for purpose.

The methodology enabled the BLF to produce a ranking of the PCTs with the largest estimated COPD population. For the PCTs with the highest estimated COPD population the commissioned supplier provided a detailed breakdown of the population lifestyle segments most likely to be at risk – these segments varied depending on the underlying population of each PCT area.

In 2008-09, following the success of the work undertaken in the Invisible Lives report, the BLF were awarded a grant of £50,000 to fund a pilot to evaluate the potential of using telephone contact to reach people who are undiagnosed and most at risk of COPD.

The report showed that South Tyneside had the highest proportion of people at risk of future hospital admission with COPD in the UK. The data indicated that 62 per cent of the population of South Tyneside was more at risk of future hospital admission with COPD than the UK average. 

The BLF approached South Tyneside PCT, to run a campaign alongside the telemarketing pilot to raise awareness of COPD and encourage early diagnosis among at risk groups.

The PCT recognised the importance of this and the potential to reduce future emergency hospital admissions, and matched the funding from the Department of Health to enable the BLF to run an integrated COPD awareness and telemarketing campaign.

Data and strategy

In January 2009 the BLF launched a Love Your Lungs campaign aimed at finding some of the many people in South Tyneside area who were thought to have undiagnosed COPD to encourage them to seek diagnosis and treatment.

The campaign had three integrated elements:

• Four Love Your Lungs events were run at venues where the key at-risk lifestyle segments were most likely to spend time/shop.
• 5,000 people from the most at-risk lifestyle segments were contacted by phone before the events to encourage them to attend. The telephone numbers for the campaign were qualified as belonging to the most at-risk lifestyle types who were also most likely to be responsive to a telemarketing campaign.
• The BLF worked to involve local communities in the campaign by speaking to GPs, pharmacists, and community health centres in the areas identified as having the largest at-risk populations. Libraries and community centres were encouraged to support the campaign, through sending campaign materials for display in these settings.
• The BLF also attended meetings with the local practice based commissioning group and the primary care trust to harness the support of the local GPs and healthcare professionals.

The results

Telemarketing

Phase one

• 5,000 calls
• 1,822 information packs sent
• 1,176 of these requested future contact
• 65 contact referrals were passed to the helpline
• Overall conversion rate of 58.70 per cent

Phase two (those requesting follow-up call six weeks later)

• Overall conversion rate for further information or helpline advice of 88.90 per cent
• Lung testing events results: four events in Majestic Bingo, Morrisons and Asda
• Total number of people attending events: more than 2,850
• Total number of people tested: 657
• Total number of people referred to GP with abnormal lung function – 153 (23.2 per cent)
• Total number referred to smoking cessation - 94 (14 per cent)

Post event evaluation

COPD awareness

• 66 per cent said the event had increased their awareness of causes of COPD
• Since the event 183 people have told others about COPD (77 per cent) and over 94 per cent recommended the test to another person

Lung health and behaviour change

• 28 per cent said since the event they were trying to take more exercise to improve lung health
• 24 per cent felt since visiting the stand they were trying to eat more healthily in order to improve lung health

Smoking behaviour

• 18 per cent of smokers who attended the stands have changed their smoking habits by giving up, cutting down or being influenced to stop. Only 2 per cent said the event had not influenced their smoking habits. 5 per cent said they had already contacted a smoking cessation team or they intended to in the future

 Smoking cessation team results – post campaign report provided by South Tyneside stop smoking service

• 84 smokers accessed information readily available
• 56 had CO readings
• 18 people picked up information to give to a smoker they know
• 12 smokers signed up to smoking cessation intervention if offered within the workplace (at Majestic Bingo)

The exact saving of these results to the NHS is difficult to calculate, but it is likely that these people would have remained undiagnosed and without treatment and their conditions would have become more severe and when eventually diagnosed more costly to treat.

Assuming that each of these people would have been admitted to A&E at some point in the future, and this admission will now be prevented, the minimum saving to the NHS is approximately £10,000.

The true benefit of early diagnosis is in the increased sense of wellbeing that the COPD sufferers will feel now that they can manage their conditions and regain their independence and enjoyment of activities that they were almost certainly finding painful.

As well as the initial results from the South Tyneside campaign the BLF were also able to analyse the data against a series of control campaigns. This comparison of the targeted data-driven approach of the South Tyneside campaign to 17 other less targeted but otherwise very similar events run by the BLF over the course of the last year revealed that the targeted approach was:

• more effective at reaching the most at-risk population
• considerably more effective at reaching people who were likely to be receptive to having their lungs tested
• more successful at finding people who needed to be referred to a GP for further tests.

From the top target type identified as having the population most at risk of developing COPD:

• From the 17 “control” COPD awareness events 44 people had their lungs tested.
• From the four South Tyneside events 123 people had their lungs tested.

This represents an increase of just under 300 per cent

The proportion of the most at-risk lifestyle segments attending the South Tyneside event was also compared with the underlying South Tyneside population. The BLF found that in South Tyneside the proportion of most at-risk lifestyle segments tested was far higher than the proportion from the other events, demonstrating the benefits of a targeted approach to health interventions and proving the validity of the model.

Strengths of the project

A social marketing approach to changing people’s behaviours towards their health and wellbeing is now widely used in the primary care sector and has undoubtedly had a significant impact on the health of the nation.

The missing element of the social marketing revolution has always been robust evaluation and a clear action plan has to how the learning can be replicated in other areas of the country to make better uses of resources, share costs and fully transfer learning.

The British Lung Foundation’s Love Your Lungs campaign is an example of excellent data strategy purely based on the results of the campaign and the way in which it fused sophisticated marketing techniques such as risk modelling, population segmentation, communications tone and channel propensities with traditional health data.

More importantly, the campaign has been evaluated against control campaigns to truly prove for the first time that varying the style of health intervention offered using robust data analytics and marketing techniques can produce better health outcomes for the British population.

Love your Lungs is currently being replicated in two other primary care trust areas, and the BLF team are sharing their learning, data strategy and targeted approach with healthcare organisations across the country.