The RECAP (Remote COVID-19 Assessment in Primary Care) project emerged as a collaboration between the University of Oxford and Imperial College London with the aim of developing a tool to assist primary care providers in the identification of those COVID-19 patients at risk of becoming severe, in order to facilitate the rapid escalation of their treatment and increase the chances of better outcomes.
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Why it is important
Since its outbreak in Wuhan (China) in November 2019, coronavirus has claimed more than 1,500,000 lives globally and 64,000 in the UK, according to the World Health Organisation, causing disruption in even the strongest health systems in the world. New methods to assess and improve the management of patients are essential to maximise safety for patients and health care providers, particularly given the chance that SARS-Cov-2 may become a regular pathogen in our health services. RECAP project aims to assist primary care providers in improving patient care and health outcomes through analysis of de-identified patient data.
How it can benefit patients
Most patients with COVID-19 will be diagnosed and managed remotely in primary care settings. This is desirable as hospital visits are associated with an increased risk of infection transmission, health expenditure and acute care service saturation. However, patients with COVID-19 may present with a variety of symptoms, whose evolution seems insidious and difficult to predict with the remote diagnostic and assessment tools currently available for primary care clinicians. The RECAP risk prediction tool will bring benefits for patients by providing clinicians a systematic way for assessment and guiding decision on patient’s treatment and management according to their likelihood of severity, which may contribute to decreasing morbidity and mortality.
Summary of current research
The aim of this project is to develop and validate a primary care early warning score (RECAP – Remote COVID-19 Assessment in Primary Care): that is specific to COVID-19 and based on data that can be reliably collected during a remote GP consultation. We will recruit patients with clinically diagnosed COVID-19 and presenting in primary care. Data will be captured at each patient contact (for patients being monitored daily) and linked to data on subsequent outcomes, including admission to hospital and admission to ITU as measures of clinical deterioration. This linked data will be accessible through NIHR Imperial BRC’s iCARE environment and the Royal College of General Practitioner’s Research and Surveillance Centre (RSC), based at the University of Oxford. The relationship between patient’s characteristics and hospital outcomes will help identify the risk factors and comorbidities of patients, presenting in primary care with COVID-19 symptoms, that indicates they are at risk of rapid deterioration. This national study to develop and validate the RECAP score, builds on initial work done by the RECAP team at the University of Oxford’s Nuffield Department of Primary Care Health Sciences to develop a consensus of data elements likely to contribute to a primary care risk score.
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Key individuals behind the study
Imperial Team:
| Chief Investigator | Professor Brendan Delaney |
| Co-Investigator | Mr Erik Mayer |
| Co-Investigator | Dr Ana Luisa Neves |
| Co-Investigator | Dr Francesca Fiorentino |
| Researcher | Dr Ana Belen Espinosa-Gonzalez |
| Researcher | Mr Denys Prociuk |
| Researcher | Ms Ella MI |
| Researcher | Ms Emma MI |
Oxford Team:
| Chief Investigator | Professor Trish Greenhalgh |
| Co-Investigator | Professor Simon de Lusignan |
| Co-Investigator | Dr Sara Ward |
| Co-Investigator | Dr David Nunan |
| Researcher | Dr Paul Thompson |
| Researcher | Ms Laiba Husain |
| RSC practice liaison officer | Mr Jack Macartney |
Funders
- Community Jameel Imperial College COVID-19 Excellence Fund
- NIHR Oxford Biomedical Research Centre
- NIHR Imperial Biomedical Research Centre
- NIHR Imperial Patient Safety Translational Research Centre
- Economic and Social Research Council