A combination of study designs are required to evaluate all aspects of the service:
* Participatory action research approach, involving real-time evaluation at each clinic to inform subsequent clinics
* Before-and-after study for patient outcomes pre-clinic attendance and post-clinic attendance.
* Qualitative methods (interviews, focus groups)
Evaluation of the clinic cycles will include consideration of qualitative data from patients, carers and healthcare professionals, in addition to quantitative outcomes for service implementation and patient factors (i.e. uptake of the service and benefits realised in-session), including those in the following areas:
* Clinic process
* Education and supported self-management
* Added value of diagnostic tools (new diagnoses)
* Applicability and use of treatment tools and treatment tailoring
* Self-monitoring appropriateness and uptake
* Balance measures (e.g. increased secondary care traffic)
The longer-term impact of the service will be evaluated using clinical and health service outcomes such as:
* Hospitalisations for airways disease
* perceived disease control (symptom scores etc)
* exacerbation frequency
* health-related quality of life
* Patient Activation Measures (PAM)
* Treatments used
* Healthcare resource use (primary and secondary care)
