Admission prevention in COPD: non-pharmacological management

Abstract

Exacerbations of chronic obstructive pulmonary disease (COPD) are one of the commonest causes of hospital admission in Europe, Australasia, and North America. These adverse events have a large effect on the health status of the patients and impose a heavy burden on healthcare systems. While we acknowledge the contribution of pharmacotherapies to exacerbation prevention, our interpretation of the data is that exacerbations continue to be a major burden to individuals and healthcare systems, therefore, there remains great scope for other therapies to influence exacerbation frequency and preservation of quality of life. In this review, the benefits and limitations of pulmonary rehabilitation, non-invasive ventilation, smoking cessation, and long-term oxygen therapy are discussed. In addition, supported discharge, advanced care coordination, and telehealth programs to improve clinical outcome are reviewed as future directions for the management of COPD.Please see related article: http://www.biomedcentral.com/1741-7015/11/181.

Does Telehealth Monitoring Identify Exacerbations of Chronic Obstructive Pulmonary Disease and Reduce Hospitalisations? An Analysis of System Data

“…This would seem to suggest, as in other studies [17,31,32], that telehealth monitoring fails to achieve the objective of keeping patients out of hospital or reduce health service usage. However, our analysis suggests that there may be a way to identify AECOPDs with enough time to intervene and thus prevent hospital readmission.…”

Non-invasive positive pressure ventilation and exercise training in patients with stable hypercapnic chronic obstructive pulmonary disease

“…This result is in accordance with that of Hui et al [35], Hildegrade et al [36] and Spencer et al [37] who found no changes in PFTs while dyspnea and HRQoL had a significant improvement. Suh et al [14] had explained this result as ; during exercise training there is improvement in skeletal muscle performance and reduced lactate production which enhances the relationship between respiratory muscle load and capacity. This is achieved through modifications in breathing pattern with optimization of pulmonary mechanics, and reduction in exertion related dyspnea with further improvement in skeletal muscle performance.…”

“…Clinical manifestations of these physiologic changes are reflected as reduced dyspnea, improved health related quality of live (HRQoL) [14], and potentiated the benefits of rehabilitation program [15].…”

Tele-nursing in patients with chronic illness: a systematic review

“…Un 56% (n=19) de los estudios seleccionados 10,14,16,18,20,[25][26][27][28][29][30][31][32][33][34][35][36][37][38][39] identificaron el soporte virtual como una de las principales características de la tele-enfermería. Se caracteriza principalmente por el uso de páginas web o videos con fines educativos 25,27 , incluyendo formularios auto-evaluativos, enlaces a páginas web de interés y cursos de formación para fomentar un mayor automanejo y adaptación del paciente con el proceso crónico 30 .…”

“…Nueve de los estudios seleccionados 10,17,28,35,36,[40][41][42][43] (26%) presentaron el seguimiento telefónico como otra de las características clave de la tele-enfermería, cuyo objetivo es llevar a cabo una atención individualizada y específica de la conviven-cia del paciente con la enfermedad 36,38 . El seguimiento telefónico consiste en la planificación semanal de llamadas a través de las cuales el profesional sociosanitario fomenta una relación terapéutica 41 con el paciente donde este es el foco de atención, solventando las dudas referentes a su día a día con la enfermedad crónica 16,28,43 .…”