An interview study exploring the experiences, expectations
and understanding of exacerbations of COPD patients and
their carers before and after the emergence of COVID-19 (EXACQUAL)

Study Design: Qualitative Study
Disease Area: Respiratory
Funder: Astra Zeneca
Sponsor: Astra Zeneca
Chief Investigator: Dr Ann Hutchinson


An interview study exploring COPD patients and their carers experiences, expectations and understanding of exacerbations before and after the emergence of COVID-19.

Chronic obstructive pulmonary disease (COPD) is a common lung disease which causes sufferers to experience episodes of breathlessness, with symptoms worsening over a short period of time. Such episodes, termed exacerbations of COPD, often require treatment with medication and are a common reason for emergency department attendance and hospital admission.

Exacerbations reduce quality of life and are associated with an increased risk of mortality. Previous research has found episodes of exacerbation to be a very distressing experience for COPD patients. Despite this, some patients do not seek medical assistance during such episodes. The impact of COVID-19 on exacerbations of COPD may also have changed treatment seeking behaviour. There is limited research on the language used to describe exacerbations of COPD and how exacerbations that do not lead to hospital attendance are identified and managed by COPD patients at home. As such, the study aims to improve our knowledge of COPD patients and their carers understanding, experiences and expectations of COPD exacerbations before and after the emergence of COVID-19.

What we plan to do

Adopting a qualitative study design, semi-structured interviews will be held with up to 40 COPD patients, and where appropriate their carers, who are i) prone to moderate and/or severe COPD exacerbations or ii) not prone to moderate or severe COPD exacerbations. The study plans to understand what differences may be present between people who have frequent exacerbations requiring medical assistance and those who have exacerbations for which they don’t seek medical assistance, exploring the relationship between COPD experience and subsequent exacerbation behaviour.

The study aims to improve our knowledge of COPD patients and their carers understanding of, feelings towards, experiences and expectations about exacerbations. The study will ask about how COVID-19 has affected COPD patient experience of exacerbations. Thematic analysis will be applied to identify, analyse and interpret themes from the qualitative interview data.

Astra Zeneca will act as the sponsor for the study. HHTU will provide study management support and data management for the ExacQual Study.

Chief Investigator

Prof Mike Crooks Consultant Respiratory Physician- Hull University Teaching Hospitals

HHTU Study team

Dr Ann Hutchinson -  Research Fellow
Dr Matt Northgraves - Trial Manager
Prof Judith Cohen - Director HHTU
John Turgoose - Information Systems Manager
Amy Porter - Trial Administrator

Email address


Participating Sites and their Project Investigators

  • Holderness Health Dr Margaret Ikpoh
  • Hull University Teaching Hospitals Prof Mike Crooks
  • Southern Health NHS Foundation Trust Tricia Munroe
  • University College London Dr Kay Roy

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Other Dissemination

The PI of EXACQUAL Dr Ann Hutchinson has worked with artist Anna Bean to create artworks and animations based on the descriptions of COPD participants provided during their interviews. You can find details of this interesting work here.