This article is part of Pulmonology Advisor‘s coverage of the CHEST 2018 meeting, taking place in San Antonio, Texas. Our staff will report on medical research related to COPD, critical care medicine, and more conducted by experts in the field. Check back regularly for more news from CHEST 2018.
SAN ANTONIO — When patients who were admitted to the hospital for an acute exacerbation of chronic obstructive pulmonary disease (COPD) received a discharge care bundle, hospital readmissions were significantly reduced, according to findings presented at the CHEST Annual Meeting, held October 6-10, in San Antonio, Texas.
In 2016, researchers conducted a prospective cohort study with pre and postintervention arms. A total of 371 patients were included (preintervention, n=150 and postintervention, n=221) who had similar characteristics. The researchers developed an evidence-based COPD care bundle with 3 primary objectives: (1) prior to discharge, patients must receive COPD education by healthcare providers; (2) patients must complete an individualized self-management COPD action plan to be used after discharge; and (3) a timely follow-up appointment with a pulmonologist must be scheduled.
The COPD care bundle was initiated in April 2017. The education portion of the intervention included information about the disease itself, lung cancer screening, and pulmonary rehabilitation, as well as proper inhaler technique. The COPD action plan included learning about signs and symptoms that would require an emergency pulmonary physician visit. The third intervention required a follow-up visit to occur within 7 days of discharge. The researchers collected data on hospital length of stay, discharge location, and readmission rates for both groups.
The postintervention group had significantly lower 30-day readmission rates compared with the preintervention group (22.2% vs 32.7%; P =.024). Furthermore, 60-day and 90-day readmission rates were 30.3% and 35.3% in the postintervention group compared with 56.0% and 62.6% in the preintervention group (P <.001 for both). Both groups had similar lengths of hospital stay (8 days vs 7 days, respectively; P =.322).
“A multidisciplinary discharge program can easily be implemented and can improve patient outcomes in those admitted with [an acute exacerbation] of COPD,” the researchers concluded. “Such a program should be considered in all hospitals.”
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Kendra M, Shah C, Landry L, et al. A discharge bundle reduces readmissions in patients with acute exacerbation of COPD. Presented at: CHEST Annual Meeting 2018; October 6-10, 2018; San Antonio, TX.