Data on admissions were extracted from the hospital records at the end of the trial . The number of admissions identified was cross referenced with the admissions reported by the patients to ensure that we captured events occurring away from the patients ' usual hospital . The cause of the admission ( and thus whether the event counted as a primary outcome ) was assessed independently from the hospital discharge summary by HP and BM with disagreements resolved by discussion ( with WM arbitrating , if necessary ) . Questionnaires were administered by a research nurse at a home visit arranged within two weeks of the calendar year during which the participant was in the trial . Healthcare resource use was collected by questionnaire posted to the participants three , six , and nine months ( one reminder ) and by the research nurse at baseline and the 12 month assessment . Healthcare resource use included consultations with GPs and nurses , respiratory and nursing teams , out of hours services , emergency services , telephone calls to the NHS 24 health information and self care advice service , and courses of oral steroids and antibiotics . The respiratory physiotherapy service in Edinburgh and the nurses in Midlothian maintained detailed timesheets of all patient contacts . All data were entered manually onto the trial database , with 10 % checked for accuracy by an external assessor .