Near-patient testing (NPT) allows clinical decisions to be made in a rapid and convenient manner and is often cost effective. In COPD the peripheral blood eosinophil count has been demonstrated to have utility in providing prognostic information and predicting response to treatment during an acute exacerbation. For this potential to be achieved having a reliable NPT of blood eosinophil count would be extremely useful. Therefore, we investigated the use of the HemoCue® WBC Diff System and evaluated its sensitivity and specificity in healthy, asthmatic and COPD subjects. This method requires a simple skin prick of blood and was compared to standard venepuncture laboratory analysis. The HemoCue® WBC Diff System measured the peripheral blood eosinophil count in healthy, asthma and COPD subjects with very close correlation to the eosinophil count as measured by standard venepuncture. The correlations were unaffected by disease status. This method for the measurement of the peripheral blood eosinophil count has the potential to provide rapid near-patient results and thus influence the speed of management decisions in the treatment of airway diseases.

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Introduction: The COPD STARR study (Stratified TreAtment to Reduce Risk in COPD) is an observational study performed in GP practices in the Thames Valley region to understand inflammatory characteristics in COPD. To maximise recruitment, a new peripatetic research model was performed, with two dedicated research nurses aligned to 8 practices over a large geographical area. Methods: Subjects with COPD, defined according to clinical history & spirometry, were entered into STARR. Data sampling at study entry included baseline demographics & near-patient testing for a 5-point differential cell count, using the HemoCue ®. A patient satisfaction survey was undertaken in a sample of recruited patients. Patients were asked to rate from 1-5 their experience of participation of STARR with 1 being the least and 5 being the best response. Results: Between March and August 2016, 158 COPD subjects (103 males), with a mean (range) age was 71 years (46 to 94) were recruited. The response rate was 75%. This was the first research experience in 68% of the respondents. Overall, the research experience was felt to be very good (mean score 4.3) and that this helped participants to manage their condition quite a lot better (mean score 2.9). Overwhelmingly, participants felt that their experience meant that they would take part in research again and that location was important (93% and 68% favoured responses respectively). Conclusion: COPD patients in primary care enjoy taking part in research and key to research success is location and dedicated research teams.

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