1. A pragmatic stepped intervention cluster randomized trial
V-CAPS
Vietnam COPD, Asthma
and Prevention of Smoking
An integrated health-sector strategy to combat COPD and asthma in Vietnam
A pragmatic stepped intervention cluster randomized trial

2. Aim Objectives Aim & objectives
Current status
Milestones
Challenges
Aim
Improve management of chronic lung disease and reduce smoking rates among patients and healthcare workers within government health facilities
Objectives
Evaluate the effectiveness of a COPD/asthma management intervention upon reducing exacerbations of COPD or asthma
Evaluate the effect of a health system smoking cessation intervention upon the rate of sustained abstinence among smokers
V-CAPS
Vietnam COPD, Asthma and Prevention of Smoking

3. Baseline data collection finished
Current status
Aim & objectives
Milestones
Challenges
Evaluates the clinical characteristics of patients with chronic lung disease and smoking, and current practices within the health system to manage these conditions
Baseline data collection finished and two cohorts expected to complete follow-up in December 2019
V-CAPS1
Phase 2 planning
workshop
Inaugural meeting
V-CAPS3
V-CAPS4
V-CAPS2
Characterising the current practices and attitudes regarding disease management and tobacco control, which includes both qualitative interviews of stakeholders and a health facility-wide assessment of tobacco control practices
Baseline data collection finished
V-CAPS
Vietnam COPD, Asthma and Prevention of Smoking

4. Current status V-CAPS1 V-CAPS3 V-CAPS4 V-CAPS2 Phase 2 planning
Aim & objectives
Milestones
Challenges
Pilot study to test the feasibility of COPD/asthma management intervention and health system smoking cessation intervention
The study will start shortly at 3 district hospitals in Hanoi
V-CAPS1
Phase 2 planning
workshop
Inaugural meeting
V-CAPS3
V-CAPS4
V-CAPS2
2*2 factorial cluster randomized controlled trial to assess the effectiveness of the two interventions
The study will commence mid 2019 in 4 provinces
V-CAPS
Vietnam COPD, Asthma and Prevention of Smoking

5. Milestones V-CAPS1 1,404 patients in baseline full survey (Men: 76.2%)
Aim & objectives
Current status
Challenges
V-CAPS1
V-CAPS2
V-CAPS3
V-CAPS4
Baseline data: COPD/Asthma among patients presenting to health facilities
1,404 patients in baseline full survey
(Men: 76.2%)
974 with respiratory symptoms
(Men: 65.7%)
V-CAPS
Vietnam COPD, Asthma and Prevention of Smoking

6. Milestones
Aim & objectives
Current status
Challenges
V-CAPS1
V-CAPS2
V-CAPS3
V-CAPS4
Baseline data: COPD/Asthma among patients presenting to health facilities
V-CAPS
Vietnam COPD, Asthma and Prevention of Smoking

7. Milestones V-CAPS1 7,954 patients aged ≥ 15 enumerated (Men: 48.7%)
Aim & objectives
Current status
Challenges
V-CAPS1
V-CAPS2
V-CAPS3
V-CAPS4
Baseline data: smoking behaviours among patients presenting to health facilities
7,954 patients aged ≥ 15 enumerated
(Men: 48.7%)
1,404 participated in baseline full survey
(Men: 76.2%)
V-CAPS
Vietnam COPD, Asthma and Prevention of Smoking

8. Milestones
Aim & objectives
Current status
Challenges
V-CAPS1
V-CAPS2
V-CAPS3
V-CAPS4
Baseline data: smoking behaviours among patients presenting to health facilities
V-CAPS
Vietnam COPD, Asthma and Prevention of Smoking

9. Milestones
Aim & objectives
Current status
Challenges
V-CAPS2
V-CAPS1
V-CAPS3
V-CAPS4
Baseline data: attitudes and health-seeking behaviour
Baseline data: among patients who have a diagnosis of COPD or asthma
Patients came to various healthcare facilities, back and forth, before diagnosed with COPD/asthma at provincial or national level
Lack of following up after the acute treatment at the facilities without COPD program
Lack of awareness of the medicines prescribed
Inconsistent referral mechanism among the facilities
Lack of affordability of outpatients with health insurance
V-CAPS
Vietnam COPD, Asthma and Prevention of Smoking

10. Milestones
Aim & objectives
Current status
Challenges
V-CAPS2
V-CAPS1
V-CAPS3
V-CAPS4
Baseline data: smoking behaviours among healthcare workers (n = 2,757)
V-CAPS
Vietnam COPD, Asthma and Prevention of Smoking

11. Milestones V-CAPS3 Pilot study to test the feasibility of
Aim & objectives
Current status
Challenges
V-CAPS3
V-CAPS1
V-CAPS2
V-CAPS4
Pilot study to test the feasibility of
(a) COPD/asthma management intervention
(b) Health system smoking cessation intervention
3 district clinics in rural Hanoi
Under development and ethics approval
Expected to implement soon
V-CAPS
Vietnam COPD, Asthma and Prevention of Smoking

12. Milestones
Aim & objectives
Current status
Challenges
V-CAPS4
V-CAPS1
V-CAPS2
V-CAPS3
2*2 factorial cluster randomized controlled trial to
assess the effectiveness of
(a) COPD/asthma management intervention
(b) Health system smoking cessation intervention
40 district clinics in 4 provinces
Hanoi, Thanh Hoa, Ho Chi Minh City, and Ca Mau
Expected to commence in mid 2019
V-CAPS
Vietnam COPD, Asthma and Prevention of Smoking

13. Patients recruited for COPD/asthma management intervention
Milestones
Aim & objectives
Current status
Challenges
V-CAPS3
V-CAPS4
V-CAPS1
V-CAPS2
Proposed COPD/asthma management intervention
Patients recruited for COPD/asthma management intervention
Step 1.
(a) As-needed budesonide/formoterol
(b) Respiratory disease management plan
Poor control at follow-up OR
Acute exacerbation
Step 2.
Maintenance budesonide/formoterol
As-needed budesonide/formoterol
(c) Respiratory disease management plan
Poor control at follow-up OR
Acute exacerbation
Step 3.
Refer to specialist care for further assessment
V-CAPS
Vietnam COPD, Asthma and Prevention of Smoking

14. Milestones V-CAPS3 V-CAPS4
Aim & objectives
Current status
Challenges
V-CAPS3
V-CAPS4
V-CAPS1
V-CAPS2
Proposed health system smoking cessation intervention
Implementation of smoke-free hospital policy
Initial brief smoking cessation advice by staff
Smoking cessation materials provided at baseline
Follow-up: integrating phone call and two-way text message system
V-CAPS
Vietnam COPD, Asthma and Prevention of Smoking

15. Study approval by Ministry of Health
Challenges
Aim & objectives
Current status
Milestones
Study approval by Ministry of Health
The government approval through the MOH has introduced some delays. We have collaborated with key agencies to enable the MOH to proceed with this process as quickly as possible.
Insurance coverage
We are working with the Vietnamese government to add inhaled medications to the public health insurance subsidy list at a local level. This will be essential for the interventions to be scaled up following the study.
V-CAPS
Vietnam COPD, Asthma and Prevention of Smoking

16. A pragmatic stepped intervention cluster randomized trial
V-CAPS
Vietnam COPD, Asthma
and Prevention of Smoking
An integrated health-sector strategy to combat COPD and asthma in Vietnam
A pragmatic stepped intervention cluster randomized trial